Medication Reconciliation and Medication Error Prevention in an Emergency Department of a Tertiary Care Hospital

Abstract

Objective: The study was conducted to assess the effectiveness of the medication reconciliation and medication error prevention in an emergency department of a tertiary care hospital. Materials and Methods: Patients of either sex, aged above 18 years admitted for more than 24 hours irrespective of their medical diagnosis and for whom medication reconciliation was done were included. Patients' home medication charts were compared with their current admission medication charts to check the number of home medications that were being continued to be administered during their hospital stay. Each home medication that was not ordered or commented on was deemed to represent a discrepancy. The discrepancies were classified according to the criteria of the Safer Healthcare Now! Campaign and reasons for not continuing the drug were also documented. The interventions were brought to the notice of the concerned physician. Results: Of 80 patients (43 males and 37 females; mean age 61 ± 15 years), 74 patients had medication discrepancies categorised as documented intentional discrepancies, undocumented intentional discrepancies and unintentional discrepancies and 6 patients had no discrepancies. There was a statistically significant association between number of home medications and discrepancies, both undocumented intentional discrepancies (P=0.005) and unintentional discrepancies (P=0.049). Conclusion: This study recommends the need for additional resources and educational initiatives for the health care professionals to improve medication reconciliation. For effective medication reconciliation, patients or their care takers must help the physicians and other health care professionals involved in reconciliation by bringing all their home medications at the time of hospital admissions.

Assessment, Evaluation and Analysis of the Medication Errors of the Patients Admitted at the Emergency Department of a Tertiary Care Teaching Hospital of a South Indian City

“…In a total of 287 prescription errors, strength of the drug was not mentioned in 194 drugs (67.6%). This result is similar to the study conducted by Poornima et al, a total of 131 errors, strength of the drug was mentioned in 42 drugs (32.06%) [10].…”

“…Their study shows that, in 30 cases 26 medication errors were identified. In which 44 (33.58%) DDIs were obtained, and thus it becomes the leading error in their study [10].…”

“…The most common errors that occurred were in the administration phase (36%), and the most common type was improper dose/quantity (18%). The ED lacks the ability for directly follow-up, and thus, adverse interactions between medications prescribed in the ED may go unnoticed by the providers [10].…”

Impact of pharmacist's directed medication reconciliation on reducing medication discrepancies during transition of care in hospital setting

“…Up to the researchers’ knowledge, this is the first study to be conducted in Jordan to evaluate the value of this effective pharmaceutical care service. Results of this study add to the literature in this area, highlighting the important role of the pharmacist in detecting medication discrepancies and in preventing medical errors in the hospital setting …”

Impact of Electronic Prescribing System on Prescribing Error Rate at Patients’ Transition of Care: An Interventional Study

“…Medication errors (MEs) may occur at any stage of medication use process, 1 either in hospital or after the discharge which can lead to preventable adverse drug events. 2 MEs during discharge are responsible for onethird of the adverse drug events.…”