Development of a Screening System for Prescriptions Analysis In-Patient at Nangrong Hospital

Abstract

Background: In 2024, the inpatient pharmacy at Nangrong Hospital identified 52 level D errors, 4 level E errors, and 15 level F errors out of 321,598 inpatient prescriptions. A meeting was held to discuss strategies for detecting medication errors and to develop a system for screening and analyzing prescriptions to prevent adverse drug events (ADEs). This initiative was based on the principles outlined in the SPA Part II guideline of the 5th edition of the Hospital and Health Services Standards (2022), and utilized the PharMS program to support prescription screening and analysis in order to reduce medication errors in patient care.
Objectives: To develop a system for screening and analyzing inpatient prescriptions and to evaluate the rate and severity of medication errors before and after system development.
Methods: This study employed an action research design with data collection conducted in three phases. Phase 1 (pre-development) involved data collection from September 2024 to February 2025. Phase 2 (system pilot testing) was conducted from March to April 2025. Phase 3 (post-development) involved data collection from May to October 2025. Data were collected from 148,318 patient-days at Nangrong Hospital. Descriptive statistics and the independent chi-square test were used for data analysis, with a significance level set at 0.05.
Results: Pharmacists were able to detect prescribing errors at a rate 2.98 times higher, increasing from 4.44 incidents per 1,000 patient-days during the pre-development phase to 13.21 incidents per 1,000 patient-days after system implementation. The severity of prescribing errors decreased significantly (p-value < 0.001); severity levels E–F were detected 6 times during the pre-development phase and were reduced to zero after system implementation.
Conclusion: The development of a prescription screening and analysis system can increase the detection of prescribing errors and reduce their severity, leading to improved patient safety and more efficient pharmacist workflow.