Medication Errors and WHO Compliance in Obstetrics–Gynecology Outpatient Prescriptions: An Audit-Based Insight
Tavleen Kaur
Infection Control Department, CK Birla Hospitals-RBH, Jaipur, India.
Tanjul Saxena
Mahatma Gandhi College of Hospital Administration, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.
Swati Garg
OBG Department, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.
J Shanmugapriya *
Mahatma Gandhi College of Hospital Administration, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Outpatient medication errors are common yet preventable, and WHO prescription-writing standards are intended to enhance safety; obstetrics and gynecology (OBG) merits focused attention due to maternal–fetal risk and frequent polypharmacy.
Objectives: To quantify prescribing and omission errors, evaluate adherence to WHO prescription-writing standards, and assess the association between the number of drugs per prescription and total errors in OBG outpatient prescriptions.
Methods: A cross-sectional audit of 400 consecutively sampled OBG outpatient prescriptions over six months at a tertiary-care center used a WHO-based checklist covering patient identifiers, prescriber identifiers, drug details, and clarity; errors were categorized as prescribing or omission and graded using NCC MERP Categories A–C; descriptive statistics and regression tested the association of drugs-per-prescription with total errors; institutional ethics approval was obtained.
Results: Generic prescribing was 9% (brand 91%); dosage strength was omitted in 35.2%; dosing frequency was fully compliant in 2.8%, partially compliant with non-standard abbreviations in 81.3%, and absent in 16%; duration appeared in 95.5%; legibility was acceptable in 96.8%; diagnosis was missing in 23%; prescriber name and signature were present in 83% and 87%; most errors fell in NCC MERP Category C; drugs-per-prescription showed a positive association with total errors.
Conclusions: Substantial, remediable gaps persist in generic naming, dose strength and frequency documentation, and prescriber identifiers, compounded by error-prone abbreviations; adoption of standard operating procedures, targeted prescriber education, pharmacist review, and e-prescribing is recommended to reduce preventable harm in OBG outpatient care.
Keywords: Medication errors, WHO prescribing standards, outpatient, obstetrics and gynecology, polypharmacy