Development and validation of a ready-to-use score to prioritise medication reconciliation at patient admission in an orthopaedic and trauma department

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.

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The medication discrepancy taxonomy (MedTax): The development and validation of a classification system for medication discrepancies identified through medication reconciliation

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2019.04.005 ◽

2020 ◽

Vol 16 (2) ◽

pp. 142-148 ◽

Cited By ~ 4

Author(s):

Enas Almanasreh ◽

Rebekah Moles ◽

Timothy F. Chen

Keyword(s):

Classification System ◽

Medication Reconciliation ◽

Medication Discrepancies ◽

Medication Discrepancy ◽

Development And Validation

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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.

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