Impact of Partnered Pharmacist Medication Charting (PPMC) on Medication Discrepancies and Errors: A Pragmatic Evaluation of an Emergency Department-Based Process Redesign

Atey, Tesfay Mehari; Peterson, Gregory M.; Salahudeen, Mohammed Saji; Bereznicki, Lre; Simpson, Tom; Boland, Camille; Anderson, Eileen S.; Burgess, John; Huckerby, Emma J.; Tran, Viet; Wimmer, Barbara C.

doi:10.3390/ijerph20021452

Cited by 6 publications

(6 citation statements)

References 36 publications

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“…This limits the optimal opportunity of PPMC during patient admission which is demonstrated in previous studies. [11][12][13] A more comprehensive analysis of the PMC service to the study site would be achieved if clinical pharmacy services including PMC are provided to these areas.…”

Section: Discussionmentioning

confidence: 99%

“…13 The study showed that fewer patients in a PPMC group had at least 1 error (3.5%) than in the early BPMH (49.4%) and usual care groups (61.4%). 13 In Western Australia, PPMC was introduced at the acute medical unit, General Medicine and Nephrology at Fiona Stanley Hospital. 14 The medical officers are required to sign the order to validate the prescription.…”

Section: Introductionmentioning

confidence: 88%

“…7 One strategy to reduce MRPs and prescribing errors is the implementation of Partnered Pharmacist Medication Charting (PPMC). [8][9][10][11][12][13] PPMC has recently been adopted across hospitals globally, and in some parts of Australia. International review reported the benefits of PPMC include increased access to healthcare services, better use of pharmacists' skills and knowledge, and reduced physician workload.…”

Section: Introductionmentioning

confidence: 99%

“…2 A Tasmanian Hospital Emergency Department implemented a PPMC model involving pharmacist-documented best-possible medication history (BPMH) followed by a clinical discussion between the pharmacist and medical officer to co-develop a treatment plan and chart medications. 13 The medical officer then endorsed the medications charted before the nursing staff administered them. 13 The study showed that fewer patients in a PPMC group had at least 1 error (3.5%) than in the early BPMH (49.4%) and usual care groups (61.4%).…”

Section: Introductionmentioning

confidence: 99%

“…13 The medical officer then endorsed the medications charted before the nursing staff administered them. 13 The study showed that fewer patients in a PPMC group had at least 1 error (3.5%) than in the early BPMH (49.4%) and usual care groups (61.4%). 13 In Western Australia, PPMC was introduced at the acute medical unit, General Medicine and Nephrology at Fiona Stanley Hospital.…”

Section: Introductionmentioning

confidence: 99%

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One Year Evaluation of Pharmacist Medication Charting Service in a Principal Referral Women and Newborn Hospital

Teoh,

Mukadam,

Petrovski

2023

Hosp Pharm

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Background: Accuracy of medication charts on admission to hospital has previously shown that inadvertent omission of therapy was the most common discrepancy, accounting for 40% to 60% of errors. Partnered Pharmacist Medication Charting (PPMC) has shown to reduce medicationrelated problems. Objective: The aim of this study was to evaluate the implementation of Pharmacist Medication Charting (PMC), a derivative of PPMC, in a maternity and gynecological hospital. The occurrence of medication omission identified by the pharmacists was assessed and the pharmacist interventions involving PMC analyzed. Methods: The pharmacist interventions documented from 1st July 2022 to 30th June, 2023 were evaluated using PowerBI for data and trends on the Medication-Related Problems (MRPs) identified, occurrence of PMC, common medications charted by the pharmacists and the pharmacist recommendation and action following the identification of MRPs. Results: A total of 4898 pharmacy interventions was documented in the 12-month period. Of the total interventions documented, 1321 (26.97%) were related to pharmacist medication charting. Of all the interventions related to PMC, 53.29% involved pharmacists charting medications for the continuation or initiation of over-the-counter medications, 13.32% involved pharmacist partnered charting of Prescription Only Medications and Controlled Medications with medical staff, and 33.3% were referred to a credentialled pharmacist for PMC service. With regards to action taken following interventions involving PMC, 1065 (80.62%) were resolved following PMC. Common medications charted by the pharmacists include: macrogol and docusate laxatives (288), pregnancy multivitamin containing iron, iodine and folate (169), colecalciferol (133), iron (127), asthma inhaler (99), paracetamol and ibuprofen (88), nicotine (38), calcium (29), folic acid (26), and pantoprazole (15). Conclusion: Our study demonstrated that hospital pharmacists contribute to the reduction of MRPs, and PMC enables pharmacist to address prescribing omission and conditions untreated in the hospital. This study also reflects skills enhancement in practice for clinical pharmacists and resulted in successful implementation of PMC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

One Year Evaluation of Pharmacist Medication Charting Service in a Principal Referral Women and Newborn Hospital

Teoh,

Mukadam,

Petrovski

2023

Hosp Pharm

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Attributes of errors, facilitators, and barriers related to rate control of IV medications: a scoping review

Park,

You,

Ryu

et al. 2023

Syst Rev

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Background Intravenous (IV) medication is commonly administered and closely associated with patient safety. Although nurses dedicate considerable time and effort to rate the control of IV medications, many medication errors have been linked to the wrong rate of IV medication. Further, there is a lack of comprehensive studies examining the literature on rate control of IV medications. This study aimed to identify the attributes of errors, facilitators, and barriers related to rate control of IV medications by summarizing and synthesizing the existing literature. Methods This scoping review was conducted using the framework proposed by Arksey and O’Malley and PRISMA-ScR. Overall, four databases—PubMed, Web of Science, EMBASE, and CINAHL—were employed to search for studies published in English before January 2023. We also manually searched reference lists, related journals, and Google Scholar. Results A total of 1211 studies were retrieved from the database searches and 23 studies were identified from manual searches, after which 22 studies were selected for the analysis. Among the nine project or experiment studies, two interventions were effective in decreasing errors related to rate control of IV medications. One of them was prospective, continuous incident reporting followed by prevention strategies, and the other encompassed six interventions to mitigate interruptions in medication verification and administration. Facilitators and barriers related to rate control of IV medications were classified as human, design, and system-related contributing factors. The sub-categories of human factors were classified as knowledge deficit, performance deficit, and incorrect dosage or infusion rate. The sub-category of design factor was device. The system-related contributing factors were classified as frequent interruptions and distractions, training, assignment or placement of healthcare providers (HCPs) or inexperienced personnel, policies and procedures, and communication systems between HCPs. Conclusions Further research is needed to develop effective interventions to improve IV rate control. Considering the rapid growth of technology in medical settings, interventions and policy changes regarding education and the work environment are necessary. Additionally, each key group such as HCPs, healthcare administrators, and engineers specializing in IV medication infusion devices should perform its role and cooperate for appropriate IV rate control within a structured system.

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The impact of partnered pharmacist medication charting in the emergency department on the use of potentially inappropriate medications in older people

Atey,

Peterson,

Salahudeen

et al. 2023

Front. Pharmacol.

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Introduction: A process redesign, partnered pharmacist medication charting (PPMC), was recently piloted in the emergency department (ED) of a tertiary hospital. The PPMC model was intended to improve medication safety and interdisciplinary collaboration by having pharmacists work closely with medical officers to review and chart medications for patients. This study, therefore, aimed to evaluate the impact of PPMC on potentially inappropriate medication (PIM) use.Methods: A pragmatic concurrent controlled study compared a PPMC group to both early best-possible medication history (BPMH) and usual care groups. In the PPMC group, pharmacists initially documented the BPMH and collaborated with medical officers to co-develop treatment plans and chart medications in ED. The early BPMH group included early BPMH documentation by pharmacists, followed by traditional medication charting by medical officers in ED. The usual care group followed the traditional charting approach by medical officers, without a pharmacist-collected BPMH or collaborative discussion in ED. Included were older people (≥65 years) presenting to the ED with at least one regular medication with subsequent admission to an acute medical unit. PIM outcomes (use of at least one PIM, PIMs per patient and PIMs per medication prescribed) were assessed at ED presentation, ED departure and hospital discharge using Beers criteria.Results: Use of at least one PIM on ED departure was significantly lower for the PPMC group than for the comparison groups (χ2, p = 0.040). However, PIM outcomes at hospital discharge were not statistically different between groups. PIM outcomes on ED departure or hospital discharge did not differ from baseline within the comparison groups.Discussion: In conclusion, PIM use on leaving ED, but not at hospital discharge, was reduced with PPMC. Close interprofessional collaboration, as in ED, needs to continue on the wards.

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Impact of Partnered Pharmacist Medication Charting (PPMC) on Medication Discrepancies and Errors: A Pragmatic Evaluation of an Emergency Department-Based Process Redesign

Cited by 6 publications

References 36 publications

One Year Evaluation of Pharmacist Medication Charting Service in a Principal Referral Women and Newborn Hospital

One Year Evaluation of Pharmacist Medication Charting Service in a Principal Referral Women and Newborn Hospital

Attributes of errors, facilitators, and barriers related to rate control of IV medications: a scoping review

The impact of partnered pharmacist medication charting in the emergency department on the use of potentially inappropriate medications in older people

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