# Assessing Good Prescription Writing Practice at the Pediatric Outpatient Clinic, Atbara Teaching Hospital, Sudan: A Clinical Audit

## TL;DR

A clinical audit in Sudan's pediatric outpatient clinic found that educational interventions significantly improved prescription quality and adherence to WHO standards.

## Contribution

The study demonstrates that structured educational interventions can effectively improve prescription practices in resource-limited settings.

## Key findings

- Educational interventions led to significant improvements in prescription documentation, including patient name, age, weight, and diagnosis.
- Compliance with WHO prescribing standards increased notably after the intervention, particularly in medication details and prescriber information.
- Sustained improvements were observed across three audit cycles, indicating the effectiveness of the intervention.

## Abstract

Background

Inappropriate drug use constitutes a global health concern, especially in developing countries like Sudan, which exacerbates disease burden through medication errors, hence compromising patient safety and outcomes. Prescription auditing enhances clinical practice by improving prescription quality, aligning with WHO guidelines. This three-cycle clinical audit evaluated the impact of educational interventions on prescription writing practices, demonstrating their role in reducing prescription errors and optimizing healthcare quality, thereby addressing a pivotal public health challenge.

Methods

A prospective cross-sectional clinical audit was conducted in the Pediatric Outpatient Department of Atbara Teaching Hospital, Sudan. The audit spanned three cycles (August 2024 to February 2025), during which 60 randomly selected prescriptions per cycle were systematically evaluated. Compliance with WHO prescribing standards was assessed during the first cycle, after which an educational intervention was implemented before the second cycle. The results of this educational intervention were studied during both the second and third cycles to establish sustainability in improving prescription practices. Data analysis utilized Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States) and IBM SPSS Statistics for Windows, Version 29.0 (Released 2023; IBM Corp., Armonk, United States), with categorical variables expressed as frequencies and percentages.

Results

The first cycle in this clinical audit on 60 pediatric outpatient prescriptions done in Atbara Teaching Hospital showed some fundamental defects; 86.7% (n=52) of the prescriptions did not contain patient name, 96.7% (n=58) did not state patient age, 85% (n=51) did not provide weight, and 100% (n=60) did not mention a diagnosis. Cycle three showed a significant improvement after this intervention, with 13.3% (n=8) of the prescriptions not containing the patient's name. Age documentation improved to 86.7% (n=52), weight documentation reached 91.7% (n=55), and diagnosis documentation improved to 96.7% (n=58). Inclusion of medication generic names increased from 50% (n=30) to 88.3% (n=53), drug strength documentation increased from 28.3% (n=17) to 90.0% (n=54), and the drugs were prescribed with dosage, frequency, route, and duration in the third cycle at the rate of 98.3% (n=59), 96.7% (n=58), 98.3% (n=59), and 86.7% (n=52), respectively. The documentation of the name of the prescriber increased from 3.3% (n=2) to 81.7% (n=49), whereas prescriptions including the prescriber's signature increased from 35% (n=21) to 93.3% (n=56). These interventions improved compliance with the WHO standards of prescriptions significantly.

Conclusion

This clinical audit demonstrates that integrating structured educational interventions with prescription practice reviews significantly enhanced the adherence to WHO prescribing standards in the Pediatric Outpatient Clinic at Atbara Teaching Hospital, thereby improving medication safety and patient outcomes.