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Background and Importance Decentralised automated dispensing systems (ADS) integrated with electronic prescribing are essential tools for safe medication management in hospitals. However, unjustified use of overrides compromises traceability, therapeutic appropriateness, and patient safety. The Institute for Safe Medication Practices (ISMP) recommends restricting this functionality to justified situations under institutional guidelines, including double verification and documentation.Aim and Objectives To evaluate the appropriateness of overrides in a tertiary care hospital, analyse data from the Grifols Reporting NextGen (GRN) system and identify reasons for direct dispensing via ADS without prior medical prescription.Material and Methods A descriptive study was conducted in June 2025 in a clinical unit of a tertiary care hospital. Medication dispensed without prescription in a clinical unit was recorded. Variables collected included: justified override, medication not prescribed at any time, medication dispensed prior to prescription, medication dispensed prior to validation, and medication prescribed and validated but with deviation from the established circuit.Results Out of 6,845 dispensations via ADS, 401 were overrides (5.86%). Breakdown: 49.63% without prescription, 9.98% prior to prescription without justification, 5.23% prior to validation, 19.45% with incorrect circuit, and 15.71% prior to prescription justified.Frequently involved medications included paracetamol, morphine, omeprazole and dexketoprofen. Justification rates varied: morphine 1% ampoules (54.54%), paracetamol 1 g tablets (31.43%), omeprazole 20 mg capsules (0%), omeprazole 40 mg vials (7.14%) and dexketoprofen 25 mg/mL ampoules (15.38%).Conclusion and Relevance The analysis revealed that NPMD exceeded the 5% safety threshold (5.86%), with most cases lacking registered prescriptions or involving circuit deviations. Only 15.71% were justified, indicating a need for improved control and staff training. Recommended actions include mandatory documentation of clinical justification and periodic review of override patterns. These measures aim to optimise ADS use, enhance patient safety, and ensure therapeutic appropriateness.Conflict of Interest No conflict of interest