EVALUATION OF DRUG PRESCRIPTIONS IN A HOSPITAL EMERGENCY DEPARTMENT

This is an observational, cross-sectional study carried out between May and June 2022, with 341 medical prescriptions for medicines in a hospital emergency room in the interior of Bahia - Brazil, whose data were analyzed through descriptive analysis.

Results:

80% to 89% of the prescriptions adhered to the safety recommendations; the item with the highest adherence was identification of the date of the prescription, and the lowest adherence was having drugs with similar names identified in upper case or bold. Around 18.63% (n=514) of the drugs prescribed are on the list of potentially dangerous drugs for hospital use.

Conclusion:

The evaluation of medical prescriptions for medicines highlighted existing barriers in clinical practice, which makes it possible to develop more effective mechanisms to promote patient safety.

KEYWORDS:
Drug Prescriptions; Patient Safety; Adverse Events; Hospital Emergency Department.

Variables	n	%
Sector
Medication room	231	67.74
Men’s wing	51	14.96
Women’s wing	59	17.30
Prescriber
Diarist	97	28.45
On duty	92	26.98
Specialist	152	44.57
Specialist
General Surgery	51	33.55
Cardiologist	18	11.84
Vascular Surgery	31	20.39
Neurosurgeon	13	8.55
Orthopedist	39	25.66
Drug group (according to ATC)
Anti-infective	269	10.43
Gastrointestinal Tract and Metabolism	613	23.77
Blood and blood-forming organs	152	5.89
Cardiovascular System	702	27.22
Nervous System	702	27.22
Other^* * Other groups: Antineoplastics and immunomodulators, systemic hormones, excluding sex hormones and insulins, drugs used for skin conditions, organs of the sense, genitourinary system and sex hormones, musculoskeletal system, and respiratory system, presented in a single group due to their low frequency about the others.	141	5.47

Variables	n	%
Percentage of total adherence to prescriptions
<79	128	37.54
80 - 89	173	50.73
90 - 99	40	11.73
100	0	0
First Block - Adherence to prescription identification items (%)
Patient’s full name without abbreviations	337	98.95
Medical record number	334	97.87
Ward/apartment	173	50.67
Bed number/letter	87	25.51
Prescriber’s full name	334	97.94
Professional Council registration number	338	99.15
Prescriber’s signature/password	335	98.26
Full name of institution	337	98.86
Identification of the prescription date	339	99.38
Second Block - Adherence to drug identification items
It has abbreviations	149	5.78
Contains abbreviated route of administration as standardized by the institution	2530	98.18
Standardized in the Brazilian Common Denomination	2547	98.80
Has medicines with similar names identified in bold or upper case	06	0.23
Uses non-metric measurement expressions (spoon, ampoule, vial)	359	13.92
Pharmaceutical form with all the necessary information	2007	77.82
Unit of measurement indicated, in the case of micrograms written in full	2449	94.96
Uses a period instead of a comma when prescribing a dose	08	0.31
Use zero before the comma (e.g., 0.5g instead of 500mg);	93	3.61
Uses expressions such as “continuous use” or “non-stop” related to the duration of treatment	490	19.00
Expression “if necessary” with dosage, posology, maximum daily dose, and condition determining use or discontinuations of use	358	13.88
Contains information on diluents	96	3.72
Setting the infusion rate	31	1.20

Variables	n	%
Anti-infective
<79	164	60.97
80 - 89	75	27.88
90 - 99	9	3.35
100	21	7.81
Total	269	100
Blood and blood-forming organs
<79	52	34.44
80 - 89	41	27.15
90 - 99	08	5.30
100	50	33.11
Total	151	100
Cardiovascular system
<79	99	14.10
80 - 89	257	36.61
90 - 99	35	4.99
100	311	44.30
Total	702	100
Nervous system
<79	362	51.57
80 - 89	218	31.05
90 - 99	13	1.85
100	109	15.53
Total	702	100
Gastrointestinal tract and metabolism
<79	370	60.36
80 - 89	109	17.78
90 - 99	15	2.45
100	119	19.41
Total	613	100
Other^* * Other groups: Antineoplastics and immunomodulators, systemic hormones, excluding sex hormones and insulins, drugs used for skin conditions, organs of the sense, genitourinary system and sex hormones, musculoskeletal system, and respiratory system, presented in a single group due to their low frequency to the others.
<79	61	42.96
80 - 89	47	33.10
90 - 99	5	3.52
100	29	20.42
Total	142	100
Potentially Dangerous Medicines for Hospital Use
<79	348	67.84
80 - 89	50	9.75
90 - 99	20	3.90
100	100	19.49
Total	513	100

Universidade Federal do Paraná Av. Prefeito Lothário Meissner, 632, Cep: 80210-170, Brasil - Paraná / Curitiba, Tel: +55 (41) 3361-3755 - Curitiba - PR - Brazil
E-mail: cogitare@ufpr.br

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[1] Corresponding author: Laiza Carvalho Costa, Universidade Federal da Bahia, Instituto Multidisciplinar em Saúde, Campus Anísio Teixeira, Rua D, 15, Boa Vista, Vitória Da Conquista - Bahia, Brasil, E-mail: laiza.ccosta@hotmail.com