Medications and patient safety in the trauma setting: a systematic review

Abstract

Background Medication errors account for the most common adverse events and a significant cause of mortality in the USA. The Joint Commission has required medication reconciliation since 2006. We aimed to survey the literature and determine the challenges and effectiveness of medication reconciliation in the trauma patient population. Materials and methods We conducted a systematic review of the literature to determine the effectiveness of medication reconciliation in trauma patients. English language articles were retrieved from PubMed/Medline, CINAHL, and Cochrane Review databases with search terms “trauma OR injury, AND medication reconciliation OR med rec OR med rek, AND effectiveness OR errors OR intervention OR improvements.” Results The search resulted in 82 articles. After screening for relevance and duplicates, the 43 remaining were further reviewed, and only four articles, which presented results on medication reconciliation in 3041 trauma patients, were included. Two were retrospective and two were prospective. Two showed only 4% accuracy at time of admission with 48% of medication reconciliations having at least one medication discrepancy. There were major differences across the studies prohibiting comparative statistical analysis. Conclusions Trauma medication reconciliation is important because of the potential for adverse outcomes given the emergent nature of the illness. The few articles published at this time on medication reconciliation in trauma suggest poor accuracy. Numerous strategies have been implemented in general medicine to improve its accuracy, but these have not yet been studied in trauma. This topic is an important but unrecognized area of research in this field.

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

“…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.…”