Getting to Complete and Accurate Medication Lists During the Transition to Home Health Care

Champion, Claire; Sockolow, Paulina S.; Bowles, Kathryn H.; Potashnik, Sheryl; Yang, Yushi; Pankok, Carl; Le, Natasha B.; McLaurin, Elease; Bass, Ellen J.

doi:10.1016/j.jamda.2020.06.024

Cited by 10 publications

(14 citation statements)

References 17 publications

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“…This lack prevents medication reconciliation from being performed, increasing the risk of medication errors both by professionals and by users who are often confused about the drugs to be taken and do not receive adequate therapeutic education about the purpose and use of the therapy itself. Champion et al (2021) emphasize the impact of data on shared electronic drugs (interoperability) for therapeutic reconciliation. Härkänen et al (2020) described incident reporting in medication administration in home care setting, delivered from practical and registered nurses.…”

Section: Medication Reconciliation and Medication Errorsmentioning

confidence: 99%

Medication errors' causes analysis in home care setting: A systematic review

Dionisi

Simone

Liquori

et al. 2021

Public Health Nursing

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Many studies analyze the medication errors in the hospital setting, but the literature involving the home care setting seems scarce. The aim of this study is to identify the main risk factors that affect the genesis of medication errors and the possible solutions to reduce the phenomenon in the home care setting. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The critical analysis of the literature shows that medication errors in home care occur mainly during transitional care. The main risk factors related to transitional care are poor interprofessional communication, lack of a standardized process for medication reconciliation, the widespread use of computerized tools, and the inadequate integration of the pharmacist into the care team. The strategies to reduce the risk of errors from therapy at home are the implementation of the pharmacist in the health team to ensure accurate medication reconciliation and the use of computerized tools to improve communication between professionals and to reduce the dispersion of information. K E Y W O R D S adverse drug reaction, home care setting, medication errors, nurses 1 BACKGROUND Currently, patient and care safety represents a truly global challenge (World Health Organization [WHO], 2017). In this context, the greatest efforts are focused on medication errors, which represent between 30% and 50% of all errors in healthcare (Dionisi et al., 2021a; Meyer-Massetti et al., 2018b) and unexpected but predictable events that jeopardize patients' health (Giannetta et al., 2020b; National Coordinating Council for Medication Error Reporting & Prevention, 2015; Yetzer et al., 2011). Medication errors were defined as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing, order communication, product labeling, packaging and nomenclature, compounding, dispensing, distribution, administration, education, monitoring, and use (National Coordinating Council for Medication Error Reporting and Prevention, 2015).This phenomenon is well documented and studied in literature; several studies document the risk and impact that these events generally have. Among the causes most reported in the literature, we found several factors: inadequate staffing levels (Giannetta et al., 2021), excessive workload and hasty work (Di Simone et al., 2020), and problems related to medication proprieties (Giannetta et al., 2019a(Giannetta et al., , 2019b.Many studies analyze these factors focusing on the hospital setting with few studies instead in the home care setting that seems scarce 876

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Section: Medication Reconciliation and Medication Errorsmentioning

confidence: 99%

Medication errors' causes analysis in home care setting: A systematic review

Dionisi

Simone

Liquori

et al. 2021

Public Health Nursing

View full text Add to dashboard Cite

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“…Note that 3 themes from Irani’s research did not emerge in our study: “ Working within agency standards to meet productivity requirements ,” “ social factors ,” and “ identification of patients who were prescribed high risk medications .” This outcome was unexpected as most patients had high risk medications. 21 While patient education was included in the care plan, it was not mentioned as critical to the decision, perhaps because nurses did not fully articulate his/her thinking process.…”

Section: Discussionmentioning

confidence: 99%

“…This outcome was unexpected as most patients had high risk medications. 21 While patient education was included in the care plan, it was not mentioned as critical to the decision, perhaps because nurses did not fully articulate his/her thinking process.…”

Section: Decision Rationalementioning

confidence: 99%

Planning the Episode: Home Care Admission Nurse Decision-Making Regarding the Patient Visit Pattern

Sockolow

Bowles

Pankok

et al. 2021

Home Health Care Management & Practice

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During home health care (HHC) admissions, nurses provide input into decisions regarding the skilled nursing visit frequency and episode duration. This important clinical decision can impact patient outcomes including hospitalization. Episode duration has recently gained greater importance due to the Centers for Medicare and Medicaid Services (CMS) decrease in reimbursable episode length from 60 to 30 days. We examined admissions nurses’ visit pattern decision-making and whether it is influenced by documentation available before and during the first home visit, agency standards, other disciplines being scheduled, and electronic health record (EHR) use. This observational mixed-methods study included admission document analysis, structured interviews, and a think-aloud protocol with 18 nurses from 3 diverse HHC agencies (6 at each) admitting 2 patients each (36 patients). Findings show that prior to entering the home, nurses had an information deficit; they either did not predict the patient’s visit frequency and episode duration or stated them based on experience with similar patients. Following patient interaction in the home, nurses were able to make this decision. Completion of documentation using the EHR did not appear to influence visit pattern decisions. Patient condition and insurance restrictions were influential on both frequency and duration. Given the information deficit at admission, and the delay in visit pattern decision making, we offer health information technology recommendations on electronic communication of structured information, and EHR documentation and decision support.

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“…These issues cause the nurse to spend time finding, eliciting, and documenting information, including making telephone calls to physicians and pharmacists. 12 These workflow issues persist in HHC EHRs despite work done over 10 years ago on the human (recipient, provider), task, technology (including HIT), and environmental factors influencing HHC effectiveness, quality, and safety. 50 At that time, funded workshops and consensus studies 51,52 highlighted the need to explore HHC issues from a human factors perspective and to make recommendations for improving care provided in the home.…”

Section: Clinician Level Challenge: Work Flow Support/human Factorsmentioning

confidence: 99%

“…HIT solutions are needed to enhance data access, data processing and analysis, and information representation to increase efficiency, accuracy, and effectiveness. Although some state-of-the-art HHC HIT systems may enable interoperability of demographics and medication lists from hospital EHRs, 12 or documentation using clinical guidelines, these capabilities are not universal and do not address the range of capabilities needed.…”

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confidence: 99%