Utilization of Medication Bags To Improve the Medication Reconciliation Process and Identify Medication Errors in a Heart Failure Clinic

Background: Pharmacists have an important role in implementing drug reconciliation. The implementation of drug reconciliation allows the process of identifying drug administration errors due to information gaps, which we can avoid by optimizing information as early as possible at every shift in the process of providing health services through the reconciliation process. This process is crucial, especially for groups of patients with chronic diseases who have a high risk of changing health care delivery settings. Failure to identify results in errors in administering drugs that lead to worsening clinical conditions, resulting in increased service needs and health costs. Objective: Provides information about the tendency of pharmacists who work at the UPTD Bali Mandara General Hospital to reduce drug use errors through the drug reconciliation program. Methods: Thematic analysis of structured interview results. Results: Almost all participants (6 out of 8 pharmacists) tend to be willing to be involved in the drug reconciliation process. There are three main themes of consideration that underlie the tendency of pharmacists to be willing to be involved in the drug reconciliation process, namely, related to understanding the definition, purpose, and consistency of the implementation of reconciliation. In controlling the incidence of medication errors, the biggest preventable errors through medication reconciliation are drug duplication and drug discrepancy. Conclusion: The tendency for pharmacists to be involved is good, and the tendency to control the risk of medication errors is still lacking in terms of communication and consistency in filling out by all officers. Keywords: Pharmacist’s role, drug reconciliation, risk of medication errors

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Medication Discrepancies Involving Hospitalized Children At A High-Complexity Public Hospital

10.21203/rs.2.17865/v1 ◽

2019 ◽

Author(s):

Divaldo Pereira de Lyra ◽

Thaciana dos Santos Alcântara ◽

Fernando Castro de Araújo Neto ◽

Helena Ferreira Lima ◽

Dyego Carlos S. Anacleto de Araújo ◽

...

Keyword(s):

Medication Errors ◽

Medication Reconciliation ◽

Public Hospital ◽

Hospital Readmissions ◽

High Complexity ◽

Dose Frequency ◽

Cross Sectional ◽

Medication Discrepancies ◽

Internal Transfer ◽

Reconciliation Process

Abstract Background: Children are more susceptible to medication errors and adverse reactions. In addition, variation in body mass and medication discrepancies are the major causes of medication errors, which pose a risk of harm to children. When unresolved, these issues can lead to longer hospital stays, increased hospital readmissions, and emergency room care that burden the healthcare system. Many organizations have struggled to implement medication reconciliation. In this context, studies demonstrated that reliability and improvement science methods can be used to implement a successful and sustained medication reconciliation process. One of the initial steps involved in medication reconciliation process is determining the sector for implementation. Therefore, the aim of this study was to determine the prevalence of medication discrepancies occurring throughout the course of a hospital stay and describe the types of discrepancies and medications most commonly involved in pediatric cases. Methods: A cross-sectional study was carried out from July 2017 to March 2018 in the pediatric department of a high-complexity public hospital in Brazil. Data collection consisted of: collection of sociodemographic data, clinical interview with the patient's caregiver, registration of patient prescriptions, and evaluation of medical records. Discrepancies were classified as intentional or unintentional and included omission of medication, therapeutic duplicity, different dose, frequency, route of administration than prescribed. Study approved by the Research Ethics Committee (CAAE: 36927014.4.0000.5546). Results: During care transitions, 114 children were followed. Patients presented unintentional discrepancies, of which 16 (14.0%) presented discrepancies at hospital admission, 42 (36.8%) during ward transfer, and 52 (45.6%) during discharge. Omission represented 74% (n=20) ofthe errors at admission, 38% (n=26) at ward transfer, and 100% (n=80) at discharge. The most frequent discrepancies in the three transitions were related to antimicrobials, representing 43.3% of discrepancies at admission, 38.8% at internal transfer, and 61.2% during discharge. Conclusion: The results demonstrated that the main transition levels when unintentional discrepancies occurred in children in this hospital were during internal transfer and discharge and indicated difficulties in interprofessional communication and poor documentation. Evaluation of all transition points is essential for determining the most critical point in the quality of care provided at hospitals.

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