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.

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.

Medication discrepancies in hospitalized cancer patients: Do we need medication reconciliation?

2020 ◽  
pp. 107815522094638
Author(s):  
Maram Abu Moghli ◽  
Rana Abu Farha ◽  
Khawla Abu Hammour
Keyword(s):  
Cancer Patients ◽  
Critically Ill ◽  
Medical Records ◽  
Medication Reconciliation ◽  
Treatment Plan ◽  
Common Type ◽  
University Hospital ◽  
High Rate ◽  
Convenience Sample ◽  
Medication Discrepancies

Objective This study aimed to identify and point out the number and types of medication discrepancies among cancer patients admitted to Jordan University Hospital. Method This is a cross-sectional observational study that was conducted on cancer patients in the internal medicine department at Jordan University Hospital, Amman, Jordan. During a period of six months, a convenience sample of cancer patients was recruited, and their medical records were reviewed to collect information regarding their demographics, clinical, and medication information. Also, patients’ Best Possible Medication History (BPMH) was collected using different methods, and a comparison between patients’ BPMH and their current medications was conducted where discrepancies were recognized. Results Seventy-eight medical records were reviewed, with a total of 166 discrepancies identified. Of these, 110 discrepancies (66.3%) were unintentional. Exactly 67.9% of the study participants ( n = 53) were found to have at least one unintentional discrepancy, with the most common type being omissions ( n = 71, 65.1%,) and the second most common type being additions ( n = 16, 14.7%). Most of the discrepancies ranged between low to moderate in severity. Fifty-six (33.7%) intentional undocumented discrepancies (documentation errors) were also identified. Conclusion This study revealed a high rate of medication discrepancies among hospitalized cancer patients, most commonly unintentional omissions. Nevertheless, undocumented intentional discrepancies can equally harm this critically ill population. So, do we need medication reconciliation in cancer patients? Yes. Cancer patients are critically ill, and therefore more effort should be paid towards implementing medication reconciliation services in their treatment plan.

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.

Measurement of Empathy Levels in Undergraduate Paramedic Students

2013 ◽  
Vol 28 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Brett Williams ◽  
Mal Boyle ◽  
Tracy Earl
Keyword(s):  
Medical Condition ◽  
Cross Sectional Study ◽  
First Year ◽  
Significant Variable ◽  
Health Provider ◽  
Patient Relationship ◽  
Publication Type ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Assessment And Treatment

AbstractIntroductionParamedics rely on establishing a health provider-patient relationship with patients that promotes two-way communication, patient satisfaction, and facilitates appropriate patient assessment and treatment. Paramedics also must have an ability to empathize with patients and their family members in order to develop a successful health provider-patient relationship. The objective of this study was to assess paramedics’ empathy and attitudes toward patients with specific conditions.MethodsThis was a cross-sectional study using a convenience sample of first-, second-, and third-year, Australian undergraduate paramedic students. Student empathy levels were assessed using two standardized self-reporting instruments: the Jefferson Scale of Physician Empathy (JSPE) Health Professional (HP) version and the Medical Condition Regard Scale (MCRS).ResultsA total of 94 paramedic students participated in the study. The JSPE demonstrated that male paramedic students had higher mean empathy scores than did female paramedic students (113.25 and 107.5, respectively; P = .042). The JSPE empathy level scores were lowest among first-year paramedic students (mean = 107.53); age was not found to be a significant variable on empathy scores. The Medical Condition Regard Scale revealed lowest scores in compassion towards substance abuse (mean = 46.42).ConclusionsThe results of this study provide the discipline of paramedic health care with useful data, and provide students, academics, and other educators with important information regarding the improvement of the health provider-patient relationship and paramedic education curriculum development.WilliamsB, BoyleM, EarlT. Measurement of empathy levels in undergraduate paramedic students. Prehosp Disaster Med. 2013;28(2):1-5.

A Pressor Effect of Noncardioselective Beta Blockers in Mildly Hypertensive Patients During Surgery Under Anesthesia

Angiology ◽  
1991 ◽  
Vol 42 (10) ◽  
pp. 805-811 ◽  
Author(s):  
Ton J.M. Cleophas ◽  
Lies M. V. Asselt ◽  
Nelly H. Oudshoorn ◽  
Sajid U. Quadir
Keyword(s):  
Beta Blockers ◽  
Pressor Effect ◽  
Hypertensive Patients

Holistic Nurse Practitioner Care Including Promotion of Shared Decision-Making

2021 ◽  
pp. 089801012110627
Author(s):  
Elizabeth Kinchen
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Medical Condition ◽  
Holistic Care ◽  
Special Focus ◽  
Free Text ◽  
Shared Decision ◽  
Convenience Sample

The purpose of this quantitative, descriptive, exploratory study was to gauge the degree to which nurse practitioners (NPs) incorporate holistic nursing values in their care, with a special focus on shared decision-making (SDM), using the Nurse Practitioner Holistic Caring Instrument (NPHCI), an investigator-developed scale. A single open-ended question inviting free-text comment was also included, soliciting participants’ views on the holistic attributes of their care. A convenience sample of NPs ( n = 573) was recruited from a southeastern U.S. state Board of Nursing's (BON) publicly available list of licensed NPs. Results suggest that NPs do indeed perceive their care to be holistic, and that they routinely incorporate elements of SDM in their care. Highest scores were accorded to listening, taking time to talk to patients, knowledge of physical condition, soliciting patient input in care decisions, considering how other areas of a patient's life may affect their medical condition, and attention to “what matters most” to the patient. Age, gender, level of education, practice specialty, and location were also associated with inclusion of holistic care. Free-text responses revealed that NPs value holistic care and desire to practice holistically, but identify “lack of time” to incorporate or practice holistic care as a barrier.

Detection of potential look-alike/sound-alike medication errors using Veterans Affairs administrative databases

2018 ◽  
Vol 75 (19) ◽  
pp. 1460-1466 ◽  
Author(s):  
Jessica M. Zacher ◽  
Francesca E. Cunningham ◽  
Xinhua Zhao ◽  
Muriel L. Burk ◽  
Von R. Moore ◽  
...  
Keyword(s):  
Medication Errors ◽  
Chart Review ◽  
Veterans Affairs ◽  
Error Rates ◽  
High Rate ◽  
Administrative Databases ◽  
Potential Error ◽  
Actual Error ◽  
History Of ◽  
History Of Use

Abstract Purpose Results of a study to estimate the prevalence of look-alike/sound-alike (LASA) medication errors through analysis of Veterans Affairs (VA) administrative data are reported. Methods Veterans with at least 2 filled prescriptions for 1 medication in 20 LASA drug pairs during the period April 2014–March 2015 and no history of use of both medications in the preceding 6 months were identified. First occurrences of potential LASA errors were identified by analyzing dispensing patterns and documented diagnoses. For 7 LASA drug pairs, potential errors were evaluated via chart review to determine if an actual error occurred. Results Among LASA drug pairs with overlapping indications, the pairs associated with the highest potential-error rates, by percentage of treated patients, were tamsulosin and terazosin (3.05%), glipizide and glyburide (2.91%), extended- and sustained-release formulations of bupropion (1.53%), and metoprolol tartrate and metoprolol succinate (1.48%). Among pairs with distinct indications, the pairs associated with the highest potential-error rates were tramadol and trazodone (2.20%) and bupropion and buspirone (1.31%). For LASA drug pairs found to be associated with actual errors, the estimated error rates were as follows: lamivudine and lamotrigine, 0.003% (95% confidence interval [CI], 0–0.01%); carbamazepine and oxcarbazepine, 0.03% (95% CI, 0–0.09%); and morphine and hydromorphone, 0.02% (95% CI, 0–0.05%). Conclusion Through the use of administrative databases, potential LASA errors that could be reviewed for an actual error via chart review were identified. While a high rate of potential LASA errors was detected, the number of actual errors identified was low.

Sign in / Sign up

Export Citation Format

Share Document