The Light Millennium, Charitable Global Human Advancement Organization, proudly presents the below research by Sithusha Perera & Sithuki Perera, Whyteleafe Junior Researchers (Sri Lanka), in support of the 2022 #WorldScienceDay theme’s #BasicSciencesForSustainableDevelopment, along with encouraging students toward further research-based projects.

The theme of World Science Day on 10 November 2022 is Basic Sciences for Sustainable Development. It is being celebrated within the International Year of Basic Sciences for Sustainable Development, which kicked off on 8 July 2022. Scientists, science communicators, and science enthusiasts are encouraged to prepare their events to celebrate #WorldScienceDay.
“The annual observance of theInternational Week ofScience and Peace, 9-15 November (A/RES/43/61), is making an important contribution to the promotion of peace. The Week encourages greater academic exchanges on a subject of universal importance while also generating greater awareness of the relationship of science and peace among the general public. Based on observances of Science and Peace Week to date, it may be expected that participation each year will increase, contributing to greater international understanding and opportunities for co-operation in the applications of science for the promotion of peace throughout the year.” #ScienceForDevelopmentAndPeace 
Source: https://www.un.org/en/observances/world-science-day/week

Whyteleafe Junior Researchers Series

Tiny Holes in Saving Hands
A Research About the Bad Effects of Doctors Unreadable Handwriting

by Sithusha Perera & Sithuki Perera, Whyteleafe Junior Researchers

29/09/2022

Introduction

A prescription is an element that connects patients and doctors. It is also known that the prescription connects the patients and the pharmacists. Therefore, if a prescription is unreadable that can be a problem. Doctors play a big helpful role in society. But we have seen that some doctors’ handwriting has been careless. Sometimes they have been unreadable to patients. Once we went with my mom to a doctor my mom got a prescription but it was unreadable. That is why we chose this research topic. We are doing this research to explore the harm of doctors’ unreadable handwriting and to explore a solution if there is one. This research will help us to have an idea about the harms of doctors’ unreadable handwriting and by using this information if there is any harm we can get together and avoid it.

Explanation of Research Questions and Objectives

Our research question was “What are the bad effects of doctors’ unreadable handwriting?”.

Our research objectives were to discover the harm of doctors’ unreadable handwriting and to find out the ways that it harms society. Next, we wanted to discover the attitude towards doctors’ handwriting, discover how to reduce the harm, and introduce that method to doctors.

Materials & Methods

In this research the priority is given to the quantitative analysis because of that we collected 135 responses via Google Forms in 13 districts(Colombo, Kaluthara, Gampaha, Kandy, Kurunegala, Kegalle, Matara, Nuwara-Eliya, Rathnapura, Galle, Mathale, Anuradhapura, Badulla) using a questionnaire including 19 questions. Mainly 15 questions were about the research and the other 4 were entry questions. After collecting the responses, we entered them into an excel sheet and analyzed them.

We interviewed persons in 4 categories to get the basics and the things we learned in the interviews will be analyzed qualitatively. The categories were doctors, specialists, health ministry officers, and GMOA officers.

Theoretical Framework

Doctors use short terms when they write prescriptions. but the reason is even sometimes doctors can’t understand them. We know that some qualified pharmacists and chemists can read those short terms. But it is a widely known fact that the number of qualified pharmacists and chemists is low in Sri Lanka. So that would harm the patients because those pharmacists would misread them. Even some qualified pharmacists struggle when reading prescriptions. There is a big obligation even to pharmacists. This doesn’t mean that doctors can get rid of their obligation just letting it to pharmacists.

Results

1. Doctors’ Handwriting in Sri Lanka

According to the analysis, 69% who were questioned in the research have got an unreadable prescription. This shows that a lot of prescriptions had been unreadable by doctors. According to that, we can prove that some doctors have been careless when writing prescriptions and they are unreadable.

But according to qualitative analysis, the interviewed professionals show that society has enlarged this situation. But they also believe that some doctors write unclear prescriptions.

The analysis shows that 52% have guessed the instructions in the prescription. This proves that doctors’ unreadable 

handwriting affects the patients and that means the prescriptions are unclear. If they guess those instructions, it would be dangerous when they get decisions. it would badly affect them and their life.

We discovered that of the people who were questioned 20% had faced a situation where their prescription has been denied by the pharmacy. This shows that sometimes pharmacists deny the prescription. This shows that as our professionals told some pharmacists can read unclear prescriptions but compared to the percentage who had got unclear prescriptions the percentage which has been denied is 30% therefore, on the other hand, some pharmacists cannot read them and even it is a bad effect to the patients.

2. Harms of Doctors Unreadable Handwriting

Based on the research, 40% who were questioned had faced inconveniences because of doctors’ unreadable handwriting. So this is a bad effect of doctors’ unreadable handwriting. So, it is evident that not only pharmacists and even patients face inconveniences. it is the first direct bad effect we found in the research.

This study revealed from 135 people about 5 had been injured because of doctors’ unreadable handwriting. This is clear evidence to show the harm done by doctors’ unreadable handwriting. According to that, of every 30 patients, 1 patient gets injured because of the doctor’s unreadable handwriting which doesn’t look pleasant. This is one of the dangerous bad effects of them.

Based on the results from 135 people about 4 have been sick because of doctors’ unreadable handwriting. That is because of misreading the instructions in the prescription. This is also a dangerous bad effect of doctors’ unreadable 

handwriting. According to this, from every 35 patients, 1 gets caught with a disease because of the doctors’ unreadable handwriting. it would even course death.

We questioned the attitude about doctors’ handwriting in the questionnaire using a method of giving marks from 0-5 informing them that when you give higher marks it means your attitude is good towards doctors. But unfortunately, nobody hasn’t given 5 marks, which means nobody is completely happy about doctors.13% have given a 0. It means they hate doctors’ handwriting. 

3. Solution

The analysis shows that 45% of people who had faced inconveniences had faced that situation from the prescriptions issued by private doctors. it means private doctors’ prescriptions are unclear compared to government hospitals and private hospitals. It shows that we need to give priority to private doctors.

The specialists who were interviewed and even the people who responded to the questionnaire were asked to use a printed system to issue prescriptions. And the specialists recommended that a printed system would reduce the faults done by doctors’ handwriting. So we suggest in this research moving to a printed issuing system. But according to specialists in Sri Lanka, some hospitals have started it. but it is really hard to spread in the whole country without big support. Until then doctors and pharmacists have a big responsibility to stop this harm. Doctors must try to write clearly, and pharmacists must inform the doctor if there is a doubt about the information.

Discussion

Some doctors say that unreadable handwriting doesn’t affect patients. but we believe that it would be good if the patients can read the information given in the prescriptions. It will help them to clear their doubts. And some doctors say that doctors’ unreadable handwriting is just only unreadable to patients. They are readable to chemists and pharmacists. But the problem is if they write a number there is a big percentage to get it wrong. Even the units can be unreadable. We believe that there are two options. The first option is to change the attitudes of doctors and make them write correctly but that is a hard step to take. So we also think that the best option is to move to a printed prescription system. But Sri Lanka even has many challenges to take that step. We must move to the printed system anyway.

By showing that about 70% have received unreadable prescriptions in this research we have proved that doctors’ handwriting has been careless. Despite that, according to our results, we found 3 main types of harm done by doctors to patients 

1. make patients inconvenience 

2. make patients injured

3. make patients sick 

4. make a patient die 

These 4 types are major and matter to patients. First, there are many ways that patients face inconveniences such as they can’t understand the instructions if a pharmacist denies the prescription, must again contact the doctor they need to meet the doctor again, and more. These things also happen in Sri Lanka as we showed in the results. It may look like a small fact but why do we keep even a small fact if we can clear them? The next 3 types may even cause death. There can be many ways to cause the next. First sometimes even as we showed in the results the patients may guess the information and make wrong decisions, second the pharmacist may guess the information and make wrong decisions. This harm is not only done by doctors, sometimes the pharmacist and chemists make errors.

According to the qualitative analysis, we can’t give the whole responsibility to doctors. In this problem the pharmacists and patients play a major role and sometimes their errors cause this problem but in society, people just only give the responsibility to doctors and they just emphasize only the wrong of doctors. That’s unfair. Sometimes doctors use short terms that are unreadable to patients, but pharmacists can read them so if they have a doubt, they must inform patients or the doctors. Even the patients must inform the doctor if they can’t read the information given on the prescription. 

So what is the solution to this matter? How can we reduce these harms? We found 3 main answers. But the majority asked to go to a printed prescription system. That would be helpful to reduce those harms. Through this research we compel the health sectors to move to a printed system. But there are obstacles in that path. But compared to the other 2 solutions, this solution is better. The other two solutions are,

1. Tend doctors to write clearly- this is also one of the solutions but there are some issues. The main issue is that it is not practical because some doctors can’t change their handwriting and to change their handwriting, we must limit the number of patients that need to be checked. Because of these reasons, it is not a practical solution.
2. Pharmacists must reject or contact the doctor if they have a doubt this will be an inconvenience to patients and the pharmacist can’t contact the doctor every time and that will be an inconvenience to the doctor too.

But we must use these two solutions as short-term plans to achieve this target until we can make a printed system of issuing prescriptions in Sri Lanka.

If we speak about the attitude of society toward doctors’ handwriting even according to the results, we can see that they have been against doctors when it comes to doctors’ handwriting. But the experts show that society has emphasized the harm of the doctor’s handwriting.

Conclusion

We did this research because we wanted to find out the harm of doctors’ unreadable handwriting to the patients in Sri Lanka and we wanted to know if there is the harm in how to reduce that.

The results showed that some doctors write unreadable prescriptions in Sri Lanka. Next according to the results we found that there are mainly 4 types of harm because of doctors’ careless handwriting. Even we found that there is an enlarged bad attitude against doctors’ unreadable handwriting in Sri Lankan society. Next, we searched for a solution to reduce the harm of doctors’ unreadable handwriting so we found two answers to them the best way to move to a printed prescription system but still, this also has many challenges. Even from the results, we found that priority must be given when patients take treatments from private doctors.

We concluded that hence there are harms of doctors’ unreadable handwriting the health sector must move to a printed prescription system.

_ . _

Declaration

We the undersigned solemnly declare that the project report is based on the work carried out during our study. We assert the statements made and conclusions drawn are an outcome of our research work.

We further certify that

I. The work contained in the report is original and has been done by us under the general supervision of our supervisor, Mr.Nalaka Swarnathilake

II. Whenever we have used materials (data, theoretical analysis, and text) from other sources, we have given due credit to them in the text of the report and given their details in the references.

Sithusha Perera & Sithuki Perera (2022/09/29)

Whyteleafe Academy

Dedicated to the 2022 World Science Day & International Week of Science and Peace byThe Light Millennium, Charitable Global Human Advancement Organization (LMGlobal.Org; 2001, New York); associated with the United Nations Department of Global Communications (formerly, UN.DPI) since 2005. www.lmglobal.org

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