Mohamed Elahdab Hassan Razan, Samir Abdulhamed Hamimy Rayan, Alshafei Elmahi Ahmed, Abdelfatah Ali Huda, Yahya Adam Wadi Wefag
Paediatrics and Child Health, Faculty of Medicine, University of Khartoum, Khartoum, SDN.
General Practice, Atbara Teaching Hospital, Atbara, SDN.
Cureus. 2025 Apr 15;17(4):e82334. doi: 10.7759/cureus.82334. eCollection 2025 Apr.
Background Inappropriate drug use constitutes a global health concern, especially in developing countries like Sudan, which exacerbates disease burden through medication errors, hence compromising patient safety and outcomes. Prescription auditing enhances clinical practice by improving prescription quality, aligning with WHO guidelines. This three-cycle clinical audit evaluated the impact of educational interventions on prescription writing practices, demonstrating their role in reducing prescription errors and optimizing healthcare quality, thereby addressing a pivotal public health challenge. Methods A prospective cross-sectional clinical audit was conducted in the Pediatric Outpatient Department of Atbara Teaching Hospital, Sudan. The audit spanned three cycles (August 2024 to February 2025), during which 60 randomly selected prescriptions per cycle were systematically evaluated. Compliance with WHO prescribing standards was assessed during the first cycle, after which an educational intervention was implemented before the second cycle. The results of this educational intervention were studied during both the second and third cycles to establish sustainability in improving prescription practices. Data analysis utilized Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States) and IBM SPSS Statistics for Windows, Version 29.0 (Released 2023; IBM Corp., Armonk, United States), with categorical variables expressed as frequencies and percentages. Results The first cycle in this clinical audit on 60 pediatric outpatient prescriptions done in Atbara Teaching Hospital showed some fundamental defects; 86.7% (n=52) of the prescriptions did not contain patient name, 96.7% (n=58) did not state patient age, 85% (n=51) did not provide weight, and 100% (n=60) did not mention a diagnosis. Cycle three showed a significant improvement after this intervention, with 13.3% (n=8) of the prescriptions not containing the patient's name. Age documentation improved to 86.7% (n=52), weight documentation reached 91.7% (n=55), and diagnosis documentation improved to 96.7% (n=58). Inclusion of medication generic names increased from 50% (n=30) to 88.3% (n=53), drug strength documentation increased from 28.3% (n=17) to 90.0% (n=54), and the drugs were prescribed with dosage, frequency, route, and duration in the third cycle at the rate of 98.3% (n=59), 96.7% (n=58), 98.3% (n=59), and 86.7% (n=52), respectively. The documentation of the name of the prescriber increased from 3.3% (n=2) to 81.7% (n=49), whereas prescriptions including the prescriber's signature increased from 35% (n=21) to 93.3% (n=56). These interventions improved compliance with the WHO standards of prescriptions significantly. Conclusion This clinical audit demonstrates that integrating structured educational interventions with prescription practice reviews significantly enhanced the adherence to WHO prescribing standards in the Pediatric Outpatient Clinic at Atbara Teaching Hospital, thereby improving medication safety and patient outcomes.
药物使用不当是一个全球性的健康问题,在苏丹等发展中国家尤为突出,它通过用药错误加剧了疾病负担,从而危及患者安全和治疗效果。处方审核通过提高处方质量,符合世界卫生组织(WHO)的指南,从而提升临床实践水平。这项为期三个周期的临床审核评估了教育干预对处方书写规范的影响,证明了其在减少处方错误和优化医疗质量方面的作用,从而应对了一个关键的公共卫生挑战。
在苏丹阿特巴拉教学医院的儿科门诊进行了一项前瞻性横断面临床审核。审核涵盖三个周期(2024年8月至2025年2月),在此期间,每个周期系统评估60份随机抽取的处方。在第一个周期评估对WHO处方标准的遵守情况,之后在第二个周期之前实施教育干预。在第二个和第三个周期研究该教育干预的结果,以确定在改善处方规范方面的可持续性。数据分析使用Microsoft Excel(微软公司,美国华盛顿州雷德蒙德)和IBM SPSS Statistics for Windows,版本29.0(2023年发布;IBM公司,美国纽约州阿蒙克),分类变量以频率和百分比表示。
在阿特巴拉教学医院对60份儿科门诊处方进行的这项临床审核的第一个周期显示出一些基本缺陷;86.7%(n = 52)的处方未包含患者姓名,96.7%(n = 58)未注明患者年龄,85%(n = 51)未提供体重,100%(n = 60)未提及诊断。在此次干预后,第三个周期有了显著改善,13.3%(n = 8)的处方未包含患者姓名。年龄记录改善到86.7%(n = 52),体重记录达到91.7%(n = 55),诊断记录改善到96.7%(n = 58)。药物通用名的列入从5个0%(n = 30)增加到88.3%(n = 53),药物规格记录从28.3%(n = 17)增加到90.0%(n = 54),并且在第三个周期中,药物以剂量、频率、途径和疗程开具的比例分别为98.3%(n = 59)、96.7%(n = 58)、98.3%(n = 59)和86.7%(n = 52)。开处方者姓名的记录从3.3%(n = 2)增加到81.7%(n = 49),而包括开处方者签名的处方从35%(n = 21)增加到93.3%(n = 56)。这些干预措施显著提高了对WHO处方标准的遵守情况。
这项临床审核表明,将结构化教育干预与处方实践审查相结合,显著提高了阿特巴拉教学医院儿科门诊遵守WHO处方标准的程度,从而提高了用药安全性和患者治疗效果。