scholarly journals P032  The burden associated with medicines reconciliation in hospitalised children

2019 ◽  
Vol 104 (7) ◽  
pp. e2.37-e2
Author(s):  
Tathier Qureshi ◽  
Chi Huynh ◽  
Rhian Isaac
Keyword(s):  
Hospital Admission ◽  
Medication Errors ◽  
Pharmacy Student ◽  
National Study ◽  
Medication Discrepancies ◽  
Paediatric Hospital ◽  
Medicines Reconciliation ◽  
Pharmacy Workforce ◽  
West Midlands ◽  
Observation Period

AimMedicines reconciliation in children is an important intervention which prevents unintended medication discrepancies and medication errors from occurring when a child moves from one setting to another, e.g. from home to hospital admission. A national study in England across multiple sites has shown that 1/3 of medication discrepancies are prevented from occurring,1 What has not been evaluated however, is the potential burden that medicines reconciliation would have on the resources, in particular on the pharmacy workforce. The overall aim of this project was to investigate the burden that is associated with admissions medicines reconciliation (AMR) in children.MethodsOver a 10 day period spanning over 4 weeks, rotational pharmacists carrying out hospital admission medicines reconciliation at a paediatric hospital in Birmingham, West Midlands were directly observed by a researcher (pharmacy student). This process was timed, and the student recorded the following observations: -The number of AMRs that were initiated within 24 hours of admissionThe number of AMRs that there completed within 24 hours of admissionThe number of completed and incomplete medicines reconciliationsThe reasons for incompletion of medicines reconciliation during the observation period.

scholarly journals Medication Discrepancy Risk Factors for Pediatric Patients With Epilepsy at Hospital Admission

2021 ◽  
Vol 26 (4) ◽  
pp. 384-394
Author(s):  
Katie Louiselle ◽  
Lory Harte ◽  
Charity Thompson ◽  
Damon Pabst ◽  
Andrea Calvert ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Hospital Admission ◽  
Medication Errors ◽  
Pediatric Patients ◽  
Medication History ◽  
Medication Discrepancies ◽  
Improvement Project ◽  
Medication Discrepancy ◽  
Increased Risk ◽  
Patients With Epilepsy

BACKGROUND Children with epilepsy are at increased risk of medication errors due to disease complexity and administration of time-sensitive medication. Errors frequently occur during transitions of care between home and hospital, a time when accuracy of medication history lists is difficult to ascertain. Adverse events likely from medication discrepancies underscore the importance of improving medication reconciliation upon inpatient intake. This quality improvement project was designed to evaluate and optimize the current medication history process in epileptic patients upon hospital admission at a pediatric academic hospital. METHODS A retrospective chart review was conducted on 30 patients with epilepsy admitted in during April, July, and October 2018 to identify unintentional medication discrepancies among 6 sources: documented medication history, inpatient orders from the electronic medical record, outpatient clinic notes, inpatient history and admission document, phone message records, and external insurance claims. RESULTS A total of 63% percent of patients had at least 1 unintentional medication discrepancy. Most discrepancies occurred with daily maintenance anticonvulsants (63%). The most common types were omission of medication history (31%) and inpatient order omissions (27%). The number of medication histories completed with at least 1 discrepancy varied across pharmacists, nurses, and physicians, yet differences were not statistically significant. CONCLUSIONS Our study found a higher incidence of anticonvulsant discrepancies compared with previous studies. This quality improvement initiative identified the absence of a standardized process as the root cause for the high incidence of anticonvulsant discrepancies in pediatric patients with epilepsy at hospital admission.

scholarly journals Medication discrepancies among hospitalized patients with hypertension: assessment of prevalence and risk factors

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rana Abu Farha ◽  
Alaa Yousef ◽  
Lobna Gharaibeh ◽  
Waed Alkhalaileh ◽  
Tareq Mukattash ◽  
...  
Keyword(s):  
Hospital Admission ◽  
Medication Errors ◽  
Medical Condition ◽  
Beta Blockers ◽  
Care Transitions ◽  
High Rate ◽  
Prior History ◽  
Convenience Sample ◽  
Medication Discrepancies ◽  
Hypertensive Patients

Abstract Background Medication errors remained among the top 10 leading causes of death worldwide. Furthermore, a high percentage of medication errors are classified as medication discrepancies. This study aimed to identify and quantify the different types of unintentional medication discrepancies among hospitalized hypertensive patients; it also explored the predictors of unintentional medication discrepancies among this cohort of patients. Methods This was a prospective observational study undertaken in a large teaching hospital. A convenience sample of adult patients, taking ≥4 regular medications, with a prior history of treated hypertension admitted to a medical or surgical ward were recruited. The best possible medication histories were obtained by hospital pharmacists using at least two information sources. These histories were compared to the admission medication orders to identify any possible unintentional discrepancies. These discrepancies were classified based on their severity. Finally, the different predictors affecting unintentional discrepancies occurrence were recognized. Results A high rate of unintentional medication discrepancies has been found, with approximately 46.7% of the patients had at least one unintentional discrepancy. Regression analysis showed that for every one year of increased age, the number of unintentional discrepancies per patient increased by 0.172 (P = 0.007), and for every additional medication taken prior to hospital admission, the number of discrepancies increased by 0.258 (P= 0.003). While for every additional medication at hospital admission, the number of discrepancies decreased by 0.288 (P < 0.001). Cardiovascular medications, such as diuretics and beta-blockers, were associated with the highest rates of unintentional discrepancies in our study. Medication omission was the most common type of the identified discrepancies, with approximately 46.1% of the identified discrepancies were related to omission. Regarding the clinical significance of the identified discrepancies, around two-third of them were of moderate to high significance (n= 124, 64.2%), which had the potential to cause moderate or severe worsening of the patient´s medical condition. Conclusions Unintentional medication discrepancies are highly prevalent among hypertensive patients. Medication omission was the most commonly encountered discrepancy type. Health institutions should implement appropriate and effective tools and strategies to reduce these medication discrepancies and enhance patient safety at different care transitions. Further studies are needed to assess whether such discrepancies might affect blood pressure control in hypertensive patients.

Epidemiology of medication discrepancies upon hospital admission in children – a systematic review

2012 ◽  
Vol 97 (5) ◽  
pp. e7.1-e7 ◽  
Author(s):  
C Huynh ◽  
Y Jani ◽  
S Tomlin ◽  
DRP Terry ◽  
AG Sinclair ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Admission ◽  
Medication Discrepancies

Impact of Pharmacy Student and Resident-Led Discharge Counseling on Heart Failure Patients

2013 ◽  
Vol 26 (6) ◽  
pp. 574-579 ◽  
Author(s):  
Andrew Szkiladz ◽  
Katherine Carey ◽  
Kimberly Ackerbauer ◽  
Mark Heelon ◽  
Jennifer Friderici ◽  
...  
Keyword(s):  
Heart Failure ◽  
Medication Errors ◽  
Pharmacy Student ◽  
Control Groups ◽  
Readmission Rates ◽  
Cost Avoidance ◽  
Significant Difference ◽  
Heart Failure Readmissions ◽  
And Control ◽  
The Impact

Purpose: Many health systems have implemented interventions to reduce the rate of heart failure readmissions. Pharmacists have the training and expertise to provide effective medication-related education. However, few studies have examined the impact of discharge education provided by pharmacy students and residents on patients hospitalized with heart failure exacerbations. Methods: This was a nonrandomized intervention study evaluating the impact of a pharmacy student and resident-led discharge counseling program on heart failure readmissions. The primary end point was the 30-day heart failure readmission rate. Secondary end points included self-reported patient understanding of medications, number of medication errors documented, and estimated associated cost avoidance. Results: A total of 86 and 94 patients were enrolled into the intervention and control groups, respectively. No statistically significant difference in readmission rates was detected between the intervention and the control groups. Thirty-four medication errors and discrepancies were documented, or 1 for every 2.5 patients counseled, resulting in an estimated cost avoidance of $4241 for the institution. Eighty-nine percent of patients who received discharge counseling agreed they had a better understanding of their medications after speaking with a pharmacy resident or student. Conclusions: There was no statistically significant difference in readmission rates; however, several medication errors were prevented, and a large percentage of patients expressed an improved understanding of their medications.

scholarly journals Identifying Unintentional Medication Discrepancies at Admission among Elderly Inpatients in Vietnam

2021 ◽  
Author(s):  
Phuong Thi Xuan Dong ◽  
Van Thi Thuy Pham ◽  
Linh Thi Nguyen ◽  
Thao Thi Nguyen ◽  
Huong Thi Lien Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Hospital Admission ◽  
Medication Reconciliation ◽  
Negative Impact ◽  
Medication History ◽  
Medication Discrepancies ◽  
Medication Discrepancy ◽  
Chronic Medication ◽  
Elderly Inpatients

Abstract Background Elderly patients are at high risk of unintentional medication discrepancies during transition care as they are more likely to have multiple comorbidities and chronic diseases that require multiple medications. The main objective of the study was to measure the occurrence and identify risk factors for unintentional medication discrepancies in elderly inpatients during hospital admission.Methods A prospective observational study was conducted from July to December 2018 in a 800-bed geriatric hospital in Hanoi, North Vietnam. Patients over 60 years of age, admitted to one of selected internal medicine wards, taking at least one chronic medication before admission, and staying at least 48 hours were eligible for enrolment. Medication discrepancies of chronic medications before and after admission of each participant were identified by a pharmacist using a step-by-step protocol for the medication reconciliation process. The identified discrepancies were then classified as intentional or unintentional by an assessment group comprised of a pharmacist and a physician. A logistic regression model was used to identify risk factors of medication discrepancies.Results Among 192 enrolled patients, 328 medication discrepancies were identified; of which 87 (26.5%) were unintentional. 32.3% of patients had at least one unintentional medication discrepancy. The most common unintentional medication discrepancy was omission of drugs (75.9% of 87 medication discrepancies). The logistic regression analysis revealed a positive association between the number of discrepancies at admission and the type of treatment wards. Conclusions Medication discrepancies are common at admission among Vietnamese elderly inpatients. This study confirms the importance of obtaining a comprehensive medication history at hospital admission and supports implementing a medication reconciliation program to reduce the negative impact of medication discrepancy, especially for the elderly population.

scholarly journals Numbers and Potential Causes of Medication Error in Inpatient Service of Rumah Sakit Islam Malang

2020 ◽  
Vol 31 (2) ◽  
pp. 127
Author(s):  
Arsy Arundina ◽  
Kurnia Widyaningrum
Keyword(s):  
Medication Errors ◽  
Data Exploration ◽  
Average Error ◽  
Inpatient Service ◽  
High Turnover ◽  
Prolonged Length ◽  
Average Error Rate ◽  
Alternative Solutions ◽  
Observation Period

<p>Medication errors, ranging from prescription to administration errors, are still problems of patient safety with an average error rate of 8% - 10% and can cause severe morbidity, prolonged length of stay (LOS) in a hospital, unnecessary diagnostic tests and care, and mortality. The objective of this study is to describe the number of medication errors and their potential causes according to the perceptions of health personnel. The study was carried out by questionnaires, interviews, and data exploration on prescriptions made before the observation period and new prescriptions made during the observation period. The priority determination of the solutions was carried out using Capability, Assessibility, Readiness, and Leverage method (CARL) and discussions with related units. The priority root factors that caused medication errors in the inpatient pharmacy at RSI Malang were high workloads and high turnover of inpatient pharmacist, incomplete prescription identity, illegible doctor's writing, and lack of training for the pharmacist. The priority outcome of the alternative solutions to overcome the medication errors in inpatient pharmacist is to regularly conduct training or knowledge refreshing for the inpatient pharmacist at RSI Malang and the implementation of e-prescription.</p>

scholarly journals 5PSQ-138 Review of medication errors in a paediatric hospital based on an institutional reporting system

2019 ◽  
Author(s):  
C San ◽  
G Bianconi ◽  
JF Meyer ◽  
A Minetti ◽  
Y De Oliveira Granja ◽  
...  
Keyword(s):  
Medication Errors ◽  
Reporting System ◽  
Paediatric Hospital
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