Clinical and paraclinical characteristics and evaluation of surgical outcomes for patients with nasal bone fractures at Hai Phong Medical University Hospital

Abstract

Background: Prescribing medications for patients with impaired renal function requires appropriate dose adjustments based on estimated glomerular filtration rate (eGFR) to minimize the risk of drug accumulation and related adverse events. However, dose adjustment is often inconsistently applied and lacks systematic implementation in routine clinical practice. Objective: To evaluate the effectiveness of a renal function–based dose adjustment alert tool integrated into the electronic prescribing system at a general hospital. Methods: A pre–post intervention study without a control group was conducted at Hai Phong International General Hospital from January to June 2025. The study included 1,000 inpatient prescriptions containing at least one active ingredient requiring renal dose adjustment based on eGFR, equally divided into pre-intervention (n = 500) and post-intervention (n = 500) groups. Data were processed and analyzed using R software with appropriate statistical tests. Results: There were no statistically significant differences in baseline characteristics (age, sex, length of hospital stay, comorbidities) between the two groups (p > 0.05). The rate of inappropriate dosing prior to intervention ranged from 6.1% to 15.0% depending on the stage of renal impairment, and decreased to between 0% and 5.6% after the intervention, with statistically significant improvements observed in some stages (p < 0.05). The physician acceptance rate of dose adjustment alerts ranged from 75.6% to 91.1%, highest in the anticoagulant and antibiotic groups. Conclusion: Integrating a renal function–based dose adjustment alert tool into the electronic prescribing system significantly reduced dosing errors and was well accepted by clinicians. Further development and long-term clinical outcome evaluations are warranted.