PS-041 Optimisation of medication reconciliation at patient admission to hospital: what about patient selection?

ObjectivesTimely and correct prescription of patients’ regular medications on admission to neurosurgical unit is noticed not to be fully compliant with set standards. This audit aims to review the practice of medication prescription by junior doctors during patient admission to a national neurosurgical unit, and to identify areas of improvement for prompt and accurate prescription.DesignProspective clinical audit.Subjects130 patients admitted to the neurosurgical unit in 2 weeks.MethodsPrescription of patient’s regular medications on admission was audited. The prescription practice was compared against the set standards, and between different settings (in-hour vs. out-of-hour, emergency vs. elective, experienced vs. new SHOs).Results18% of patients had no regular medications prescribed by clerking doctors, the majority of which were elective admissions during in-hour clerking and performed by experienced SHOs. Of the patients who had their regular medications prescribed on admission, 29% were prescribed inaccurately, and 16% in wrong doses. Total percentage of missed and error prescription was 46%, in which only 18% were corrected within 24 hours and 21% corrected up to 48 hours after admission.ConclusionsAreas of improvement identified: prescription practice of experienced SHOs during elective admissions, medication and dose check on prescription in both elective and emergency settings, medication reconciliation within 24 hours and thereafter. Changes (e.g. an alert system) are being implemented and re-audit is in plan.

Download Full-text

Analysis of the discrepancies identified during medication reconciliation on patient admission in cardiology units: a descriptive study

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.0820.2760 ◽

2016 ◽

Vol 24 (0) ◽

Cited By ~ 2

Author(s):

Natália Fracaro Lombardi ◽

Antonio Eduardo Matoso Mendes ◽

Rosa Camila Lucchetta ◽

Wálleri Christini Torelli Reis ◽

Maria Luiza Drechsel Fávero ◽

...

Keyword(s):

Drug Administration ◽

Medication Reconciliation ◽

Patient Admission ◽

Charlson Comorbidity Index Score ◽

Medication History ◽

Dose Frequency ◽

Large Hospital ◽

High Prevalence ◽

Clinical Consequences ◽

History Of

ABSTRACT Objectives: this observational study aimed to describe the discrepancies identified during medication reconciliation on patient admission to cardiology units in a large hospital. Methods: the medication history of patients was collected within 48 hours after admission, and intentional and unintentional discrepancies were classified as omission, duplication, dose, frequency, timing, and route of drug administration. Results: most of the patients evaluated were women (58.0%) with a mean age of 59 years, and 75.5% of the patients had a Charlson comorbidity index score between 1 and 3. Of the 117 discrepancies found, 50.4% were unintentional. Of these, 61.0% involved omission, 18.6% involved dosage, 18.6% involved timing, and 1.7% involved the route of drug administration. Conclusion: this study revealed a high prevalence of discrepancies, most of which were related to omissions, and 50% were unintentional. These results reveal the number of drugs that are not reincorporated into the treatment of patients, which can have important clinical consequences.

Download Full-text

The removal and morphology of intact biofilms from implanted venous access devices

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100141470 ◽

1995 ◽

Vol 53 ◽

pp. 1020-1021

Author(s):

M.A. Gregory ◽

G.P. Hadley

Keyword(s):

Patient Selection ◽

Surgical Oncology ◽

Venous Access ◽

Common Procedure ◽

Indwelling Catheters ◽

Careful Patient ◽

Novel Method ◽

The Subject ◽

Vascular Catheters ◽

Venous Access Devices

The insertion of implanted venous access systems for children undergoing prolonged courses of chemotherapy has become a common procedure in pediatric surgical oncology. While not permanently implanted, the devices are expected to remain functional until cure of the primary disease is assured. Despite careful patient selection and standardised insertion and access techniques, some devices fail. The most commonly encountered problems are colonisation of the device with bacteria and catheter occlusion. Both of these difficulties relate to the development of a biofilm within the port and catheter. The morphology and evolution of biofilms in indwelling vascular catheters is the subject of ongoing investigation. To date, however, such investigations have been confined to the examination of fragments of biofilm scraped or sonicated from sections of catheter. This report describes a novel method for the extraction of intact biofilms from indwelling catheters.15 children with Wilm’s tumour and who had received venous implants were studied. Catheters were removed because of infection (n=6) or electively at the end of chemotherapy.

Download Full-text