Addressing delays in medication administration for patients transferred from the hospital to the nursing home: A pilot quality improvement project

Ward, Katherine; Bates‐Jensen, Barbara M.; Eslami, Michelle; Whiteman, Elizabeth; Dattoma, Lucia Loredana; Friedman, Jodi; Mariano, Jeffrey DeCastro; Moore, Alison

doi:10.1016/j.amjopharm.2008.10.001

Cited by 21 publications

(32 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Medications being unavailable at the RCF were a less frequent, but important, problem [4]. Similar problems following discharge from hospital to long‐term care have been reported in North America [21,22].…”

Section: Discussionmentioning

confidence: 97%

Gaps in continuity of medication management during the transition from hospital to residential care: An observational study (MedGap Study)

et al. 2012

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

Gaps in continuity of medication management during the transition from hospital to residential care: An observational study (MedGap Study)

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Problems with continuity of medication management during transitions of care from hospitals to residential care facilities (RCFs) have long been recognised in Australia and internationally 1‐5 . Australian studies have reported that approximately 20% of patients have medication doses missed or significantly delayed after discharge to a RCF 6‐8 .…”

Section: Introductionmentioning

confidence: 99%

“…Another factor contributing to medication delays and missed doses is difficulty accessing medication in a timely manner 4,11 . It is common practice for hospitals to not supply discharge medications for patients transferring to an RCF, instead relying on RCFs’ community pharmacies to supply and deliver medications.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of medication management during transitions from hospital to residential care: a 10‐year follow‐up to the MedGap study

Elliott

Boutros

Tran

et al. 2020

Pharmacy Practice and Res

View full text Add to dashboard Cite

Background Problems with continuity of medication administration after discharge from hospitals to residential care facilities (RCFs) have been reported in Australia and internationally. The MedGap study in 2009 reported a significant decline in post‐discharge missed or delayed doses and locum doctor call‐outs at RCFs following implementation of a hospital pharmacy‐prepared interim residential care medication administration chart (IRCMAC). Aim To determine whether reductions in missed or delayed doses and locum doctor call‐outs were sustained nearly 10 years after the IRCMAC was implemented, and evaluate RCFs' use of IRCMACs and discharge medications supplied in original packaging. Method Structured telephone interviews with nurses at 52 RCFs were conducted approximately 48‐h after discharge for randomly selected patients discharged from hospitals within a major metropolitan health service in Melbourne, Australia in 2018. Results were compared with pre‐ and post‐intervention data collected using the same method in 2009. Primary endpoints were the proportion of patients for whom the RCF used the hospital‐supplied IRCMAC and discharge medications, and the incidence of missed or significantly delayed medication doses in the first 24 h post‐discharge. The number of locum doctor call‐outs was a secondary endpoint. Results RCFs received IRCMACs for 71/73 (97.3%) patients and used them for 61/71 (85.9%). Hospital‐supplied medication, in original packaging, was received for 65/73 (89.0%) patients and used for 59/65 (90.8%). One or more doses were missed or significantly delayed for 2/73 (2.7%) patients and locum doctors were called for nine patients (12.3%), which was similar to the 2009 post‐intervention study (6/226, 2.7% and 25/226, 11.1%, respectively) and significantly lower than the 2009 pre‐intervention study (37/202, 18.3% and 66/202, 32.7%, respectively; P < 0.01 for both endpoints). Nearly 100% of RCF staff believed IRCMACs and hospital‐supplied medication improved continuity of care. Conclusion Hospital pharmacy‐prepared IRCMACs and discharge medication in original packaging were highly used and valued by RCF staff, and associated with sustained low rates of missed and delayed doses and locum doctor call‐outs.

show abstract

“…2 The median time between arrival at the RCF and the first scheduled medication dose was 3 h and 'when required' (prn) medications were sometimes needed sooner. 2 In a study conducted in the USA, most patients transferred to a RCF had one or more medication doses missed; on average, 3.4 medications per patient were omitted or delayed for an average of 12.5 h. 5 In another US study, medication discrepancies related to transfers to and from hospitals and RCFs resulted in adverse drug events in 20% patients. 7 In an analysis of medication incidents that resulted in patient harm in Canadian long-term care facilities, patient transfer was identified as a common factor.…”

Section: Introductionmentioning

confidence: 99%

Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study)

et al. 2012

View full text Add to dashboard Cite

ObjectivesTo test the impact of a hospital pharmacist-prepared interim residential care medication administration chart (IRCMAC) on medication administration errors and use of locum medical services after discharge from hospital to residential care.DesignProspective pre-intervention and post-intervention study.SettingOne major acute care hospital and one subacute aged-care hospital; 128 residential care facilities (RCF) in Victoria, Australia.Participants428 patients (median age 84 years, IQR 79–88) discharged to a RCF from an inpatient ward over two 12-week periods.InterventionSeven-day IRCMAC auto-populated with patient and medication data from the hospitals' pharmacy dispensing software, completed and signed by a hospital pharmacist and sent with the patient to the RCF.Primary and secondary outcome measuresPrimary end points were the proportion of patients with one or more missed or significantly delayed (>50% of prescribed dose interval) medication doses, and the proportion of patients whose RCF medication chart was written by a locum doctor, in the 24 h after discharge. Secondary end points included RCF staff and general practitioners' opinions about the IRCMAC.ResultsThe number of patients who experienced one or more missed or delayed doses fell from 37/202 (18.3%) to 6/226 (2.7%) (difference in percentages 15.6%, 95% CI 9.5% to 21.9%, p<0.001). The number of patients whose RCF medication chart was written by a locum doctor fell from 66/202 (32.7%) to 25/226 (11.1%) (difference in percentages 21.6%, 95% CI 13.5% to 29.7%, p<0.001). For 189/226 (83.6%) discharges, RCF staff reported that the IRCMAC improved continuity of care; 31/35 (88.6%) general practitioners said that the IRCMAC reduced the urgency for them to attend the RCF and 35/35 (100%) said that IRCMACs should be provided for all patients discharged to a RCF.ConclusionsA hospital pharmacist-prepared IRCMAC significantly reduced medication errors and use of locum medical services after discharge from hospital to residential care.

show abstract

Addressing delays in medication administration for patients transferred from the hospital to the nursing home: A pilot quality improvement project

Cited by 21 publications

References 15 publications

Gaps in continuity of medication management during the transition from hospital to residential care: An observational study (MedGap Study)

Gaps in continuity of medication management during the transition from hospital to residential care: An observational study (MedGap Study)

A prospective study of medication management during transitions from hospital to residential care: a 10‐year follow‐up to the MedGap study

Impact of a pharmacist-prepared interim residential care medication administration chart on gaps in continuity of medication management after discharge from hospital to residential care: a prospective pre- and post-intervention study (MedGap Study)

Contact Info

Product

Resources

About