Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
F1000Res. 2024 Dec 20;13:269. doi: 10.12688/f1000research.144712.1. eCollection 2024.
Rational prescription writing is an important skill to master during internship. This Quality Improvement (QI) project aimed to understand the state of prescription writing among interns posted in the Department of Psychiatry, analyze the causes responsible for errors in prescription writing and bring about a change in the current practice.
The MBBS interns are posted in the Department of Psychiatry for 15 days. During day 1 to day 5 of their posting, a pre intervention phase was conducted wherein prescriptions written by interns in the Department of Psychiatry were collected. The prescriptions were scored based on 14 criteria which were selected based on World Health Organization (WHO) guidelines and Medical Council of India (MCI) ideal prescription format. During PDSA (Plan Do Study Act) Cycle 1, an educational handout was distributed to the interns containing the MCI ideal prescription format and WHO guidelines regarding prescription writing. The brochure was also verbally explained to the interns. From day 7 to day 15 of their posting, prescriptions written by the interns were collected. The prescriptions were scored using the same criteria.
During the pre intervention phase the mean total score of prescriptions was 9.54 ± 1.003. There was a significant improvement in the mean total score to 10.26 ± 0.746. There was a 7.54% improvement. There was also a significant improvement in several individual criteria.
The first PDSA cycle was successful in improving the quality of prescription writing among interns posted in the Department of Psychiatry. There is a need to implement more PDSA cycles to improve the quality still further.
合理处方书写是实习期间需要掌握的一项重要技能。本质量改进(QI)项目旨在了解精神科实习医生的处方书写现状,分析导致处方书写错误的原因,并改变当前的实践。
在精神科实习的医学生实习 15 天。在他们的实习的第 1 天到第 5 天进行干预前阶段,收集精神科实习医生开具的处方。根据世界卫生组织(WHO)指南和印度医学委员会(MCI)理想处方格式选择的 14 项标准对处方进行评分。在 PDSA(计划-执行-研究-行动)循环 1 中,向实习医生分发了一份教育手册,其中包含 MCI 理想处方格式和 WHO 关于处方书写的指南。还向实习医生口头解释了这本手册。在他们的实习的第 7 天到第 15 天,收集实习医生开具的处方。使用相同的标准对处方进行评分。
在干预前阶段,处方的平均总分为 9.54±1.003。平均总分显著提高到 10.26±0.746。提高了 7.54%。几个单项标准也有显著提高。
第一个 PDSA 循环成功地提高了精神科实习医生的处方书写质量。需要实施更多的 PDSA 循环来进一步提高质量。