(035) Best practice implementation project on handwritten prescription practices in a public hospital in Uasin Gishu County, Kenya

Publication Number: 698

Background: Prescription writing error is a common phenomenon in the health sector. Appropriate handwritten prescription practices minimize medical errors during medical drug dispensing.

Objectives: To identify the extent to which the clinicians adhere to handwritten drug prescription best practices and implement evidence-based strategies to improve compliance to handwritten prescription best practices in an out-patient department.

Methods: This evidence implementation project used the JBI Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool. JBI implementation framework for promoting evidence-based healthcare involves seven phases of activity which include: identification of practice area, engagement of change agents, context assessment and readiness to change, review of practice using evidence-based audit criteria, implement changes to practice using GRiP, re-assessment of practice using a follow-up audit, and sustainability consideration of the project.
Changes in compliance were measured using descriptive statistics embedded in JBI-PACES in the form of percentage changes from the baseline audit.

Results: There was a 100% improvement in compliance with the number of prescribers who had received education on essential features of a handwritten drug prescription. High compliance was observed in prescriptions that indicated the patient name (99%) and date of prescription (98%) in the follow-up cycle. Half of the prescriptions included a diagnosis of the disease in both the baseline and follow-up cycle. In the follow-up cycle, there was low compliance (21%) in prescriptions with legible handwriting and low compliance (27%) in drugs prescribed by generic drug names.

Conclusions: A marked improvement was observed in the number of prescriptions that contained the patient identifier and date following the implementation of handwritten drug prescription best practices. There was low use of generic drug names and most of the handwritten prescriptions were illegible in the follow-up cycle.