In any given week, 4 out of every 5 U.S. adults will use prescription medicines, over-the-counter (OTC) drugs, or dietary supplements (Aspden et al., 2006). Poor communication of a patient’s medication-use history between community practitioners and emergency department personnel contributes to many adverse drug events (ADEs) and can be a potential source of harm to patients (Pippins et al., 2008). For 2004 and 2005, it is estimated that more than 700,000 patients each year were treated in U.S. emergency departments for ADEs (Budnitz et al., 2006).
One out of every 6 of these patients required further care (e.g., hospital admission, transfer to another facility, and emergency department observation admission). During an 11-month period from September 2004 through July 2005, more than 2,000 medication error reports involving a reconciliation issue were submitted to MEDMARX (USP, Rockville, MD) (Santell, 2006). Approximately 22% of these reconciliation-related errors occurred during the hospital admission process. Cornish et al. (2005) found that roughly 54% (81 of 151) patients had at least one unintended medication discrepancy at the time of hospital admission. In another study, discrepancies among documented regimens from different sites of care were found to be highly prevalent, with up to 67% of inpatients in the study having at least one error in their medication history at the time of hospital admission (Pippins et al., 2008). Other studies support that at least 50% of all patients have had at least one unintentional medication discrepancy (Gleason et al., 2004; Lau et al., 2000).
Medication reconciliation is a process that aims to improve patient safety and reduce the risk of medical error by ensuring that healthcare providers have an up-to-date list of the medications a patient is taking. A recent study of hospitalists involved in design and implementation of medication reconciliation processes felt that medication reconciliation would likely have a positive impact on patient safety (Clay et al, 2008). This information, which can reduce therapeutic duplication and adverse drug interactions, must include the drug name, dose, and frequency. ADEs are frequent and often preventable patient safety incidents. Patients are most at risk for ADEs during transitions in care (hand-offs) across settings, services, providers, or levels of care, including community pharmacy services. The goal of “medication reconciliation” is to prevent these ADEs.
The medication reconciliation process has been demonstrated to be a powerful method for reducing ADEs and medication errors (Provonost et al., 2003; Rozich et al., 2004). However, one important aspect of medication reconciliation’s success depends on emergency department (ED) and other hospital personnel accessing the patient’s most up-to-date medication history from the outpatient setting. To do this, effective communication between community pharmacies and EDs is critical.
to read rest of article please visit Patient Safety & Quality Healthcare
No comments:
Post a Comment