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Assessment of legibility and completeness of handwritten and electronic prescriptions
Ahmed I Albarrak1, Eman Abdulrahman Al Rashidi1, Rwaa Kamil Fatani1
1College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Insights
Handwritten prescriptions have a high error rate, while electronic prescriptions significantly reduce medication errors. Legibility was adequate, but completeness was poor in handwritten forms.
Area of Science:
- Pharmacy Practice
- Health Informatics
- Patient Safety
Background:
- Handwritten prescriptions are prone to errors affecting patient safety.
- Electronic prescribing systems offer a potential solution to improve accuracy.
Purpose of the Study:
- To compare medication errors in handwritten versus electronic prescriptions.
- To assess the legibility and completeness of handwritten prescriptions.
Main Methods:
- A prospective study was conducted at King Khalid University Hospital.
- 398 prescriptions (199 handwritten, 199 electronic) were analyzed.
- Prescriptions were evaluated for legibility, completeness, and medication errors using validated checklists.
Main Results:
- Handwritten prescriptions showed a significantly higher error rate (35.7%) compared to electronic prescriptions (2.5%).
- Errors in omitted dose and route of administration were significantly lower in e-prescriptions.
- Completeness for patient identification was below 86%, and medication prescription completeness ranged from 88% to 91% for handwritten forms.
Conclusions:
- Handwritten prescriptions exhibit a high incidence of prescribing errors.
- Electronic prescribing systems substantially decrease medication errors.
- While handwritten prescription legibility was acceptable, their completeness was notably deficient.
Objectives:
To assess the legibility and completeness of handwritten prescriptions and compare with electronic prescription system for medication errors.
Design:
Prospective study.
Setting:
King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia.
Subjects And Methods:
Handwritten prescriptions were received from clinical units of Medicine Outpatient Department (MOPD), Primary Care Clinic (PCC) and Surgery Outpatient Department (SOPD) whereas electronic prescriptions were collected from the pediatric ward. The handwritten prescription was assessed for completeness by the checklist designed according to the hospital prescription and evaluated for legibility by two pharmacists. The comparison between handwritten and electronic prescription errors was evaluated based on the validated checklist adopted from previous studies.
Main Outcome Measures:
Legibility and completeness of prescriptions.
Results:
398 prescriptions (199 handwritten and 199 e-prescriptions) were assessed. About 71 (35.7%) of handwritten and 5 (2.5%) of electronic prescription errors were identified. A significant statistical difference (P < 0.001) was observed between handwritten and e-prescriptions in omitted dose and omitted route of administration category of error distribution. The rate of completeness in patient identification in handwritten prescriptions was 80.97% in MOPD, 76.36% in PCC and 85.93% in SOPD clinic units. Assessment of medication prescription completeness was 91.48% in MOPD, 88.48% in PCC, and 89.28% in SOPD.
Conclusions:
This study revealed a high incidence of prescribing errors in handwritten prescriptions. The use of e-prescription system showed a significant decline in the incidence of errors. The legibility of handwritten prescriptions was relatively good whereas the level of completeness was very low.
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