INTRODUCTION:

Medication errors were frequent, occurring at a rate of nearly 1 of every 5 doses in hospital and skilled nursing facility. On 23rd September 2010, the Patient Safety First initiative was launched in response to recommendations of the Report of the Commission on Patient Safety and Quality Assurance – Building a Culture of Patient Safety in Ireland (Department of Health and Children 2008). Medication error is defined as any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient or consumer. Such events may be related to professional practice, health care products, procedures and systems (Cohen and Mitchell, 2007).

Many errors could be prevented by decreasing availability of floor-stock medications, restricting access to high-alert drugs, and distributing new medications from the pharmacy in a timely manner (Anderson, 2011). Observation as a technique has proved to produce valid and reliable results in identifying drug errors, distractions and interruptions and has many advantages over the other techniques.

STATEMENT OF THE PROBLEM:

Auditing Of Medication Practices Related To Storage And Documentation Among Health Professionals Of PIMS.

OBJECTIVES:

1. To assess the Medication Practices with regard to Storage of Medication by Health Professionals.

2. To determine the Medication Practices with regard to Documentation of Medication by Health Professionals.

METHODOLOGY:

The present study aimed to audit the medication practices regarding storage and documentation of medication, a Quantitative Exploratory approach was considered for the present study and the research design was Non-Experimental Descriptive design. The setting is PIMS hospital. The wards that are present in the Hospital are Male and Female Medical Ward (totally 100 beds), Male and Female Surgical (100 beds), Ortho Ward (60 beds), Neuro/ENT Ward (40 beds), Male Free Ward (40 beds), Chest Medicine Ward (20 beds), Psychiatry Ward (30 beds), Dermatology Ward (30 beds), Ophthalmology Ward (30 beds), Gynae Ward (60 beds), OBG Ward (30 beds) and Pediatric Ward (21beds). ICU‘s in the hospital are Intensive Care Unit I and II (total 23 beds), Pediatric ICU (10 beds), Neonatal ICU (10 beds) and Cardiac.

RESULT:

Section A: Storage of Medication by Health Professionals:

Section I: Storage of Medicines in Cupboard by Health Professionals Section II: Storage of Medicines in Crash cart by Health Professionals Section III: Storage of Medicines in Refrigerator by Health Professionals.

Section IV: Storage of Medicines in Narcotic Cupboard by Health Professionals.

Section B: Documentation of Mecication ByHealth Professionals

Section I: Distribution of Samples based on Levels of Documentation Practices by Doctors.

Section II: Distribution of Samples based on Levels of Documentation Practices by Nurses.

A. Storage of Medicines in Cupboard based on rating scale scores

Figure 1. Level of Practices on Storage of Medicines in Cupboard

Figure 1 shows the level of storage on basis of overall scores of all the areas assessed and separately for wards and ICU‘s. Out of the 8 areas assessed, 5 (62.5%) areas had average level of practices and 3 (37.5%) of the areas had poor level of practice for storage of Medicines in Cupboard.Out of the 3 wards assessed, 2 (66.6%) of areas showed average practice and 1 (33.3%) showed poor practice.Out of the 5 ICU‘s assessed, 4 (80%) showed average practices and 1 (20%) area showed poor practice.

B. Storage of Medicines in Crash cart with regard to rating scale scores

Figure 2. Level of Practices on Storage of Medicines in crash cart

Figure 2 shows the Level of Practice of the Storage of Medicines in Crash cart with regard to the scores of the rating scale. Out of the 16 areas assessed, 2 (12.5%) areas showed good level of practice and 14 (87.5%) of areas showed average level of practice in storage of Medicines in Crash cart. Out of the 11 wards assessed, 5 (45.4%) areas showed good level of practice and 6 (54.6 %) areas showed average level of practice. Out of 5 ICU‘s, 1 (20%) area showed good level of practice and 4 (80%) areas showed average level of practice in storage of medicines in the crash cart.

C. Storage of Medicines in Refrigerator Based on Rating Scale Scores.

Figure 3. Level of Practice in Storage of Medicines in Refrigerator

Figure 3 shows the level of Practice in Storage of Medicines in refrigerator with the rating scale scores.Out of the 16 areas assessed, 13 (81.2%) areas had refrigerator.Out of the 13 areas, 7 (53.8%) had good practice for storage of Medicines in refrigerator and 6(46.1%) areas had average level of practices for storage of medicines in refrigerator.Out of 8 wards assessed, 3 (37.5%) areas showed good level of practice and 5 (62.5%) areas showed average level of practice.Out 5 ICU‘s assessed, 4 (80%) areas showed good level of practice for storage of medicines and 1 (20%) area showed average level of practice.

D. Storage of Medicines in Narcotic cupboard based on Rating scale scores

Practice related to Storage of Medicine in Narcotic cupboard

Figure 4 shows the Level of Practice related to the storage of Medicines in the Narcotic cupboard.

Out of the 2 wards having Narcotic cupboard, 1(50%) had good level of practices for storage of Medicines and 1(50%) had average level of practice for storage of Medicines.All the 5(100%) ICU‘s had good level of practice for storage of Medicines in Narcotic cupboard.

Section B: Documentation of Medication by Health Professionals

Section B. 1. Level of Practices by Health Professionals n=100

Figure 5. Level of Practice of documentation by Health Professionals

Figure 5 shows the level of practice of documentation of Medication by both Doctors and Nurses in medication chart. The overall Level of documentation by doctors and nurses showed that 96.5% of case sheets had average level of practice and the 3.5% of the case sheets had poor level of documentation.n doctors documentation, 94% of case sheets showed average level of practice and 6% of case sheets showed poor level of documentation.In nurses‘ documentation, 99% case sheets showed average level of practice and 1% case sheet showed poor level of practice of documentation.

Section B. 2. Documentation of Medication by Doctors n=100

Figure 6. Level of Practice of documentation by doctors

Figure 6 shows level of practice of documentation of Medication by doctors in wards and ICU‘s.

In 100 case sheets assessed, 71 of case sheets in general ward showed average Level of Practice and 5 case sheets showed poor level of practice.For ICU‘s, 23 case sheets showed average level of practice and 1 case sheet showed poor level of practice.

Section B. 3. Documentation of Medication by Nurses

n=100

Figure 7. Level of practice of documentation by doctors

Figure 7 shows the level of practice of documentation by nurses in wards and ICU‘s. In wards, 75 case sheets showed average level of practice of documentation and 1 case sheet showed poor Level of Practice.In ICU‘s, all the case sheets showed average level of practice.

Table 1: Range of Level of Practice for Storage

Sl No.	Storage of Medication	Range of Scores
Sl No.	Storage of Medication	Wards	ICU’s
1.	Cupboard	11-15	6-16
2.	Crash Cart	6-21	15-26
3.	Refrigerator	9-19	15-17
4.	Narcotic Cupboard	10-19	20-25

Table 1 shows the range of scores for wards and ICU‘s based on the minimum and maximum scores obtained using rating scale.

Table 2: Range of Level of Practice for Storage of Medication by Health Professionals

Sl. No.	Storage of Medication	Range of Scores
Sl. No.	Storage of Medication	Wards	ICU’s
1.	Doctors	12-27	26-27
2.	Nurses	20-33	20-33

Table 2. Shows the range of level of practice of documentation of Medicines.

The rage of scores obtained by Doctors in general ward is 12-27 and in critical care unit is 26-27.

The range of scores obtained by Nurses in wards is 20-33 and in critical care unit is also 20-33.

This chapter deals the analysis and interpretation of the findings of the study.

CONCLUSION:

The present study assessed the practices of medication regarding storage and documentation among the health professionals. The study revealed that practices mark only average scoring for both storage and documentation. So, the study concluded that the there is a need for standardized policies in the hospital that needs to be maintained throughout. Medication error is a serious matter that can affect the patient directly or indirectly. To eliminate such problems audit is necessary.

RFERENCES:

1. Acharya, Leelavathi D and Shareef. Study and evaluation of medication errors in a multidisciplinary tertiary care South Indian teaching hospital. Indian Journal of Hospital Pharmacy. 2008; 45: 54-58.

2. Ahmad A, Patel I. Parimalarkrishnan S, Mohanta GP, Parchuri and Balkrishnan R. Assessment of Medication Errors in Among Patients Visiting Community Pharmacies in Rural Areas of Chidambaram, Tamilnadu at South India: Prospective Study. International Journal of Pharmacy. 2013; 3(1): 53-58.

3. Alsulami T, Conroy Z, Sharon S, Ali I and Choonara B. Double checking the administration of medicines: what is the evidence? A systematic review. Archives of Disease in Childhood. 2012; 97(9): 833-837.

4. Anderson P. Medication Error: Don‘t let them happen to you. American Nurses Today Journal. 2011; 23(8): 45-47.

5. Callanan I, Daly C and Butler MW. Safety comes first: Are doctors enough to their initial clinical assessment notes? Irish Medical Journal. 2014; 106(10): 316-8.

6. Cheragi M, Manoocheri H, Mohammadejad E and Ehsani S. Types and causes of medication error from nurse’s view point. Iran Journal of Nurse Midwifery Residence. 2013; 18(3): 228-231.

7. Coombes I, Reid C, David M, Stowasser D and Mitchell C. Pilot of National Inpatient Medication Chart in Australia: Improving Prescribing Safety and Enabling Prescribing Training. British Journal of Clinical Pharmacology. 2011; 72(2): 338-349.

8. Hartel MJ, Lukas PS, Christoph and Stefan E. High Incedence of Medication Documentation Errors in a Swiss University Hospital due to the Handwritten Prescription. British Medical Journal. 2011; 11(3): 125-27.

9. Jain P, Sachan A, Singla RK and Agrawal P. Exploratory Study on Consumer’s Drug Knowledge Status in Haryana, India. Indo Global Journal Pharmaceutical Sciences. 2012; 2(2): 167-178.

10. Manias E, Kinney S, Cranswick N and Williams A. Medication Errors in Hospitalized Children. Journal of Pediatric Child Health. 2014; 50(1): 71-7.

Received on 09.02.2025 Revised on 18.04.2025

Accepted on 02.06.2025 Published on 03.11.2025

Available online from November 15, 2025

A and V Pub Int. J. of Nursing and Med. Res. 2025; 4(4):197-200.

DOI: 10.52711/ijnmr.2025.36

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.