Departmet of General Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
Faculty of Medical Leadership and Management, London, UK.
Postgrad Med J. 2018 Nov;94(1117):617-620. doi: 10.1136/postgradmedj-2018-136010.
Drug errors are common and can be detrimental to patients, even resulting in death. Junior doctors write most prescriptions and are therefore responsible for most errors. There is little literature about the effect of legibility of the prescriber's handwriting on the rate of drug errors. Folklore would deem doctors' handwriting to be poorer than average; however, studies have shown this to be incorrect. In fact, handwriting in general has been shown to be poor.
A random sample of prescriptions from inpatient drug charts were chosen to provide a wide spread of legibility, with an even spread of the use of upper-case and lower-case lettering. Two cohorts of 13 junior doctors and 13 non-medical controls were recruited and asked to transcribe each of the prescriptions. Results were analysed for evidence of a statistical difference in correct transcription rate between lower-case or upper-case letters.
Non-medical participants correctly transcribed only 45% of prescriptions written in lower case. This rose to 66.5% for those written in upper case. This showed strong statistical significance, p<0.005. A statistical difference was also shown for differences in transcription by junior doctors (92.3% vs 97.8%, p=0.016).
Doctors must take responsibility for the quality of the prescriptions they write, to prevent avoidable drug errors. Legibility is improved by the use of capital letters. Therefore, we recommend that the use of upper cases should become routine practice when writing drug prescriptions.
药物错误很常见，可能对患者造成伤害，甚至导致死亡。初级医生开具大部分处方，因此对大多数错误负责。关于处方医生字迹的清晰度对药物错误率的影响的文献很少。有传言称医生的字迹比一般人差；然而，研究表明并非如此。事实上，一般来说，手写体的质量很差。
随机选择住院药物图表中的处方样本，以提供广泛的清晰度，并均匀分布大写和小写字母的使用。招募了两组 13 名初级医生和 13 名非医学对照组，要求他们转录每张处方。分析结果以确定小写或大写字母之间的正确转录率是否存在统计学差异。
非医学参与者正确转录小写处方的比例仅为 45%。对于大写字母书写的处方，这一比例上升到 66.5%。这显示出很强的统计学意义，p<0.005。初级医生的转录差异也显示出统计学意义（92.3%对 97.8%，p=0.016）。
医生必须对他们所写的处方质量负责，以防止可避免的药物错误。大写字母可提高清晰度。因此，我们建议在开药物处方时应常规使用大写字母。
