Medication Reconciliation and Patient Safety in Trauma: Applicability of Existing Strategies

DeAntonio, Jonathan H.; Leichtle, Stefan W.; Hobgood, Sarah; Boomer, Laura A.; Aboutanos, Michel B.; Mangino, Martin J.; Wijesinghe, Dayanjan S.; Jayaraman, Sudha

doi:10.1016/j.jss.2019.09.041

Cited by 6 publications

(5 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Discrepancies between the SMR and patients' actual use of medicines can result in improper prescribing or medication errors, either during hospitalization or after discharge [10,11]. This is particularly relevant in acute settings where patients often cannot speak for themselves about their medication history [12]. In such cases, the SMR is a valuable resource for clinicians and pharmacists-but only if it is accurate.…”

Section: Introductionmentioning

confidence: 99%

Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication

et al. 2022

View full text Add to dashboard Cite

Medication reconciliation is crucial to prevent medication errors. In Denmark, primary and secondary care physicians can prescribe medication in the same electronic prescribing system known as the Shared Medication Record (SMR). However, the SMR is not always updated by physicians, which can lead to discrepancies between the SMR and patients’ actual use of medication. These discrepancies may compromise patient safety upon admission to the emergency department (ED). Here, we investigated (a) the occurrence of discrepancies, (b) factors associated with discrepancies, and (c) the percentage of patients accessible to a clinical pharmacist during pharmacy working hours. The study included all patients age ≥ 18 years who were admitted to the Hvidovre Hospital ED on three consecutive days in June 2020. The clinical pharmacists performed medicines reconciliation to identify prescribing discrepancies. In total, 100 patients (52% male; median age 66.5 years) were included. The patients had a median of 10 [IQR 7–13] medications listed in the SMR and a median of two [IQR 1–3.25] discrepancies. Factors associated with increased rate of prescribing discrepancies were age < 65 years, time since last update of the SMR ≥ 115 days, and patients’ self-dispensing their medications. Eighty-four percent of patients were available for medicines reconciliations during the normal working hours of the clinical pharmacist. In conclusion, we found that discrepancies between the SMR and patients’ actual medication use upon admission to the ED are frequent, and we identified several risk factors associated with the increased rate of discrepancies.

show abstract

Section: Introductionmentioning

confidence: 99%

Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication

et al. 2022

View full text Add to dashboard Cite

show abstract

“…One possible reason for this exclusion could be the growing recognition of the significance of medication reconciliation for geriatric trauma patients. [25][26][27][28] Medication errors are considered never events and serious reportable events, 29 highlighting the need for a safe and effective process to document and communicate a patient's medications throughout their care journey. Healthcare providers and institutions are required to prioritize and enforce policies that ensure medication reconciliation is implemented during care transitions, as mandated by the U.S. Joint Commission.…”

Section: Discussionmentioning

confidence: 99%

Perceived barriers and facilitators to geriatric trauma risk assessment: Instrument development and validation

Adeyemi

Konda

Grudzen

et al. 2023

Preprint

View full text Add to dashboard Cite

Background: In the fast-paced and high-stress environment of the ED, conducting a thorough and efficient risk assessment may be associated with various challenges such as time constraints and competing priorities. The aim of this study is to develop and validate a survey instrument that will comprehensively assess emergency provider and nurses perceived barriers and facilitators to geriatric trauma risk assessment. Methods: We designed two six-item surveys that each assess the barriers and facilitators to geriatric trauma risk assessment using the American College of Surgeons geriatric trauma management guidelines. Each item in the survey has a quantitative section, answered on a binary scale, and qualitative open-ended responses. Nine content experts performed content validation of the items in the scale and we computed Cohen Kappa, and item and scale content validity indices (CVIs). Results: Most of the experts were male (56%), and non-Hispanic Whites (44%). A third of the content experts are MDs. Of the six items in the perceived barriers scale, five items were retained. The Cohen Kappa value across the five items ranged from 0.4 to 0.9 and the item and scale CVIs for the five items were 0.76 each. Of the six items in the perceived facilitators to geriatric trauma risk assessment, all six items were retained. The Cohen Kappa value across the six items was 1.00 and the item and scale CVIs for the six items were 1.00 each. Conclusion: We present an instrument that can assess the perceived barriers and facilitators to geriatric trauma risk assessment experienced by emergency providers and nurses.

show abstract

“…10 The main reasons for a high number of reconciliation errors are aging, lack of understanding of treatment with medications, variable health literacy, low recall ability, difficulties in communicating a particular language, gaps in the drug history, multiple medical records for each patient, increased length of hospital stay, comorbidities, therapy with multiple drugs, complexity of medication names, doses and frequencies. [11][12][13] Pharmacists, by their knowledge and training, are ideal individuals who can identify wrong doses and routes of administration, and therapeutic duplications by obtaining medication histories and thereby assist in the reconciliation process. There are reports from literature stating that in comparison with physicians working alone, physicians working along with pharmacists during the admission process can significantly improve the accuracy of a medication history.…”

Section: Introductionmentioning

confidence: 99%

Medication Reconciliation Practices in Two Multispeciality Hospitals

Syju¹,

Abraham²,

Korath³

et al. 2023

Ind. J. Pharm. Edu. Res

View full text Add to dashboard Cite

Background: Medication errors are common and can compromise patient safety. Commonly seen at discharge, they can be identified and resolved even during admission. Medication reconciliation is recommended to prevent errors arising from medication discrepancies. Aim: To conduct medication reconciliation in two multispeciality hospitals and classify the identified medication discrepancies according to their potential to cause harm. Materials and Methods: This prospective interventional study was carried out in medicine and surgery departments of two urban hospitals over a period of six months. Patients who satisfied the criteria were enrolled and medication reconciliation was performed. Interventions were provided whenever necessary. The identified discrepancies were then given to an expert panel for classifying them based on their potential to cause harm. Results: 580 medication discrepancies were identified from a total 372 patients, drug interaction (n=345, 61.6%) was the most commonly observed discrepancy, followed by omission error (n=127, 12.9%). The medication discrepancies observed from both the hospitals were found to be statistically not significant (p=0.246). From a total of 580 discrepancies, 454 (78.27%) discrepancies were Significant, 80 (13.79%) Serious and 46 (7.93%) Not Significant. Conclusion: The results of our study show that there are discrepancies in medication use when the patient transitions in a hospital. It is recommended that medication reconciliation practices be performed by clinical pharmacist during the hospital stay to ensure continuity of healthcare and for patient safety. An electronic medical record capable of capturing and continuously updating medication information may be a long-term solution. To achieve this, professional development of clinical pharmacists is of paramount importance.

show abstract

Medication Reconciliation and Patient Safety in Trauma: Applicability of Existing Strategies

Cited by 6 publications

References 47 publications

Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication

Medicines Reconciliation in the Emergency Department: Important Prescribing Discrepancies between the Shared Medication Record and Patients’ Actual Use of Medication

Perceived barriers and facilitators to geriatric trauma risk assessment: Instrument development and validation

Medication Reconciliation Practices in Two Multispeciality Hospitals

Contact Info

Product

Resources

About