From Prescription to Administration: Ensuring Safe Medication Practices under NABH Standards

Medication safety is one of the most critical pillars of quality healthcare delivery. Errors in prescribing, dispensing, or administering medicines can lead to serious patient harm, increased hospital stays, legal complications, and loss of trust. Recognizing this, the National Accreditation Board for Hospitals & Healthcare Providers (NABH) places strong emphasis on NABH medication safety and standardized medication management systems.

This blog serves as a practical guide for hospitals and clinics in India to strengthen safe medication practices by following NABH standards across the entire medication lifecycle—from prescription to administration and monitoring.

Why Medication Safety Is Critical in NABH

Under NABH accreditation, medication management is not limited to pharmacy operations alone. It is a multidisciplinary responsibility involving doctors, nurses, pharmacists, and hospital management.

NABH focuses on:

• Antibiotic policy standardization
• Preventing medication errors
• Ensuring patient safety and rights
• Promoting rational drug use
• Standardizing medication-related processes

Hospitals that implement strong medication management NABH practices demonstrate better clinical outcomes, improved compliance, and higher patient confidence.

The Medication Management Workflow under NABH

NABH evaluates medication safety across every step of the medication lifecycle.

1. Prescription

Safe medication practices begin with accurate and complete prescriptions.

NABH requires:

• Clear, legible, and standardized prescriptions
• Usage of capital letters
• Use of generic names wherever applicable
• Defined policies for verbal and telephonic orders
• Special precautions for high-risk and look-alike/sound-alike (LASA) drugs

Electronic prescribing systems (EMR/HIS) are encouraged to minimize handwriting-related errors.

2. Transcription

Transcription errors are a common cause of medication incidents.

NABH guidelines emphasize:

• Authorized personnel for transcription
• Route and time
• Double-checking transcribed orders
• Clear documentation of dose, frequency, and route
• Avoidance of unsafe abbreviations

Hospitals must ensure traceability between prescription and transcription records.

3. Dispensing

Dispensing errors can occur due to labelling mistakes, wrong drug selection, or improper storage.

NABH medication safety standards require:

• Pharmacists & nurses’ verification before dispensing
• Proper labelling with patient details and instructions
• Segregation of LASA and high-alert medications & narcotic drugs
• Temperature-controlled storage (as before first-in-first-out or first-expiry-first-out) and stock monitoring

Pharmacies must maintain batch tracking and expiry control systems.

4. Administration

Medication administration is a high-risk stage, especially in wards, ICUs, and emergency units.

NABH mandates adherence to the “Seven Rights of Medication Administration”:

• Right patient
• Right drug
• Right dose
• Right route
• Right time
• Right reason
• Right documentation

Additional requirements include:

• Bedside verification
• Patient identification protocols
• Documentation immediately after administration
• Monitoring adverse drug reactions

5. Monitoring

Medication safety does not end with administration.

Hospitals must:

• Monitor therapeutic effects
• Report and analyze adverse drug events
• Maintain pharmacovigilance systems
• Conduct periodic medication audits
• Conduct periodic prescription audits

Continuous monitoring helps improve safe medication practices in India and supports NABH compliance.

Common Medication Risks & Errors in Hospitals

Despite best intentions, hospitals often face challenges such as:

• Illegible prescriptions
• Incomplete patient medication history
• Confusion between similar drug names
• Inadequate staff training
• Poor communication between departments
• Lack of incident reporting culture

NABH encourages hospitals to identify these risks proactively and implement corrective actions.

NABH Guidelines for Safe Medication Practices

NABH standards require hospitals to establish:

• A documented medication management policy
• Defined roles and responsibilities
• Standard operating procedures (SOPs)
• Medication error reporting and analysis systems
• Regular staff training and competency assessments

Compliance is assessed during internal audits, pre-assessments, and final NABH evaluations.

Key Medication Safety Policies Every Hospital Should Implement

To align with medication management NABH requirements, hospitals should implement:

• Near expiry policy
• Medicine purchase policy
• High-risk medication policy
• LASA drug management policy
• Verbal and telephonic order policy
• Medication storage and labelling policy
• Medicine discarding & destruction policy
• Adverse drug reaction (ADR) reporting policy
• Look-back and root cause analysis (RCA) mechanism

These policies form the backbone of a robust medication safety framework.

How Candour Solutions Helps Hospitals Improve Medication Safety Compliance

Implementing NABH medication safety standards can be complex without expert guidance. Candour Solutions, NABH Consultants in Kochi, Kerala, provides end-to-end support to hospitals and clinics across India.

Our Support Includes:

• Medication safety gap analysis
• Review and drafting of NABH-compliant policies
• Pharmacy and nursing workflow optimization
• Staff training on NABH medication safety standards
• Mock audits and corrective action planning
• Support for HIS/EMR medication modules

With hands-on experience across multiple NABH standards, Candour Solutions ensures hospitals achieve compliance while improving patient safety outcomes.

Conclusion

Medication safety is a cornerstone of quality healthcare and a critical component of NABH accreditation. By strengthening processes from prescription to monitoring, hospitals can significantly reduce errors, enhance patient trust, and meet NABH standards effectively.

Need help strengthening your hospital’s medication safety practices? Connect with our NABH experts today.
Candour Solutions is here to support your journey toward safer, compliant, and high-quality healthcare delivery.