Analysis of degree of errors in handwritten medication prescriptions in Rafha, Saudi Arabia

Purpose: To assess the prevalence of handwritten prescription errors in Rafha Central Hospital in Saudi Arabia, and to determine the most predominant type of prescription error. Methods: A cross-sectional study was carried out on randomly selected samples of hand-written prescriptions in out-patient and in-patient pharmacies of Rafha Central Hospital over a five-month period (October 2016 to February 2017). A data collection sheet specially designed for this purpose was used to collect relevant information. The collected prescriptions were analyzed for the presence of prescription errors based on prescription parameters defined by the World Health Organization (WHO) and current guidelines published in British National Formulary (BNF). Descriptive statistics and Microsoft Office were used for processing and analyzing the data collected. Results: Overall, 1019 prescription errors were identified. More than half of the total errors (610; 60 %) were associated with missing patient's information. Moreover, the parameters related to drug and prescriber information were absent in 204 (20 %) and 5 (0.4 %) prescriptions, respectively. In addition, 200 (19 %) miscellaneous errors related to date, legible handwriting and directions for patients were identified. Conclusion: This study discovered errors in hand-written prescriptions. A majority of the prescriptions did not adhere to accepted guidelines. The most common errors are absence of generic names of drugs, non-indication of duration of therapy or prescriber’s contact address, and absence of patient’s weight. Moreover, illegible handwriting was obvious in a substantial number of prescriptions

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population