Regular Medications in the Emergency Department Short Stay Unit (ReMedIES): Can Prescribing be Improved Without Increasing Resources?

Autor:	Jackson AB; St Vincent's Hospital Melbourne, Fitzroy, Melbourne, VIC, Australia., Lewis M; Monash Health, Melbourne, VIC, Australia., Meek R; Monash Health, Melbourne, VIC, Australia.; Monash University, Melbourne, VIC, Australia., Kim-Blackmore J; Monash Health, Melbourne, VIC, Australia., Khan I; Monash Health, Melbourne, VIC, Australia., Deng Y; Monash Health, Melbourne, VIC, Australia.; University of Melbourne, Parkville, VIC, Australia., Vallejo J; Monash Health, Melbourne, VIC, Australia., Egerton-Warburton D; Monash Health, Melbourne, VIC, Australia.; Monash University, Melbourne, VIC, Australia.
Jazyk:	angličtina
Zdroj:	Hospital pharmacy [Hosp Pharm] 2024 Feb; Vol. 59 (1), pp. 110-117. Date of Electronic Publication: 2023 Aug 29.
DOI:	10.1177/00185787231194999
Abstrakt:	Background: Hospital medication errors are frequent and may result in adverse events. Data on non-prescription of regular medications to emergency department short stay unit patients is lacking. In response to local reports of regular medication omissions, a multi-disciplinary team was tasked to introduce corrective emergency department (ED) process changes, but with no additional financing or resources. Aim: To reduce the rate of non-prescription of regular medications for patients admitted to the ED Short Stay Unit (SSU), through process change within existing resource constraints. Methods: A pre- and post-intervention observational study compared regular medication omission rates for patients admitted to the ED SSU. Included patients were those who usually took regular home medications at 08:00 or 20:00. Omissions were classified as clinically significant medications (CSMs) or non-clinically significant medications (non-CSMs). The intervention included reinforcement that the initially treating acute ED doctor was responsible for prescription completion, formal checking of prescription presence at SSU handover rounds, double-checking of prescription completeness by the overnight SSU lead nurse and junior doctor, and ED pharmacist medication reconciliation for those still identified as having regular medication non-prescription at 07:30. Results: For the 110 and 106 patients in the pre- and post-intervention periods, there was a non-significant reduction in the CSM omission rate of -11% (95% CI: -23 to 2), from 41% (95% CI: 32-50) to 30% (95% CI: 21-39). Conclusion: Non-prescription of regular CSMs for SSU patients was not significantly reduced by institution of work practice changes within existing resource constraints. Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2023.)
Databáze:	MEDLINE
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