Development of a Computer Program for Screening Discharge Prescriptions and Reconciling Medications in the Department of Internal Medicine, Udon Thani Hospital

Abstract

Prescription screening and medication reconciliation are essential processes in preventing medication errors and promoting patient safety. This study aimed to develop a computer program for screening discharge prescriptions and reconciling medications, and to compare prescription errors before and after the implementation of the program. This quasi-experimental retrospective study was conducted in the Medicine Department of Udonthani Hospital. A total of 14,985 discharge prescriptions were reviewed – 7,813 before and 7,172 after program implementation.

The results showed that 52 prescribing errors, corresponding to 6.65 events per 1,000 prescriptions were identified before program development. The most common error was incomplete prescriptions (dose, strength, quantity, or directions), accounting for 14 events (26.9%), followed by inappropriate dosing and omission of necessary medications, each with 7 events (13.5%). After program implementation, 66 prescribing errors corresponding to 9.20 events per 1,000 prescriptions were identified. The most common error was inappropriate dosage 31 events  (47.0%), followed by omission of necessary medications 19 event (28.8%).

The implementation of a newly developed computer program for medication order screening and medication reconciliation enhances the detection of prescribing error, particularly those involving inappropriate drug dosing and the omission of necessary medications.