Impact of a medication reconciliation program on cardiac surgery patients.

Autor: Al-Jazairi AS; 1 Pharmaceutical Care Division, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia., Al-Suhaibani LK; 1 Pharmaceutical Care Division, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia., Al-Mehizia RA; 1 Pharmaceutical Care Division, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia., Al-Khani S; 1 Pharmaceutical Care Division, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia., Lewis G; 2 Heart Center, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia., De Vol EB; 3 Biostatistics, Epidemiology, Scientific and Computing Department, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia., Saad EJ; 2 Heart Center, 37852 King Faisal Specialist Hospital and Research Center , Riyadh, Saudi Arabia.
Jazyk: angličtina
Zdroj: Asian cardiovascular & thoracic annals [Asian Cardiovasc Thorac Ann] 2017 Nov; Vol. 25 (9), pp. 579-585. Date of Electronic Publication: 2017 Oct 12.
DOI: 10.1177/0218492317738382
Abstrakt: Background Cardiac surgery patients are at high risk of medication errors. Resumption of home medications reduces the significance and number of medication errors. This could be achieved by implementing a medication reconciliation program. Patients and Methods Patients were eligible for inclusion in this prospective study if they were admitted, transferred, and/or discharged under cardiac surgery team care from September 2015 to March 2016. The primary outcome was the number and proportion of unintentional medication discrepancies. Secondary outcomes included the number of interventions to resolve discrepancies and their clinical significance, and the medication regimen complexity index and its correlation with discrepancies. Results There were 374 patients included and 1000 encounters tracked. Four-hundred and seventy (47%) of the included encounters were for adult patients. Of the 260 medication discrepancies detected, 181 (69.61%) were detected during admission. Discrepancies among adults were 0.913, 0.307, and 0.176 on admission, transfer, and discharge, respectively. Two-hundred (76.92%) of the interventions recommended by the pharmacy residents were accepted by the medical team, and the remaining were accepted with modifications, with no rejections. One-hundred and sixty-six (83%) of the accepted interventions were of high clinical significance. There was a significant correlation between the number of medication discrepancies and medication regimen complexity index on admission ( p < 0.0001, r = 0.34), transfer, and discharge. Conclusion Implementation of a medication reconciliation program in cardiac surgery units and its step-down units can be a powerful mean of identifying medication errors in post-cardiac surgery patients at admission and throughout the transition of care.
Databáze: MEDLINE