Medication reconciliation for patients undergoing spinal surgery

Kantelhardt, Pamela; Giese, Alf; Kantelhardt, Sven R.

doi:10.1007/s00586-015-3878-1

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…This may be because they believe that the BPMDL provides sufficient information to patients, GP, and/or PLTCS for continuing a patient's usual medication, and that it is not their role to prescribe the patient's usual medication at discharge. Kantelhardt et al [28] similarly reported that medications prescribed by surgeons on discharge were primarily related to postoperative care. A study by Murphy et al [29] found that discharge medication errors occurred in 90 % of cases prior to implementation of a MedRec discharge process in a general surgical ward.…”

Section: Discussionmentioning

confidence: 92%

“…Glintborg et al [26] also found that medication information was generally not properly transmitted at discharge. Kantelhardt et al [28] reported that discharge prescriptions by surgeons were predominantly related to postoperative care. And Murphy et al [29] found discharge medication errors for almost every patient discharged from a surgical ward.…”

Section: Discussionmentioning

confidence: 98%

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Medication at discharge in an orthopaedic surgical ward: quality of information transmission and implementation of a medication reconciliation form

et al. 2016

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Background Medication reconciliation (MedRec) at discharge is a cumbersome but necessary process to reduce the risk of medication errors at transitions of care. The main barriers to implementing such a process are the large number of professionals involved and a lack of collaboration among caregivers. Objective This study was designed to assess the need for a medication reconciliation form at discharge in an orthopaedic surgical ward. Setting The study was conducted in the orthopaedic surgery ward among inpatients at a 407-bed French teaching hospital. Method We first performed a retrospective audit to evaluate the quality of discharge medication information in the medical record, after which a 5-week prospective study was conducted in 2013. All patients admitted to the orthopaedic surgery unit who had at least two chronic diseases and three medications underwent MedRec at discharge. We designed a Best Possible Medication at Discharge List (BPMDL) to be completed by hospital staff and transmitted to community caregivers. Mean outcome measures We assessed the completeness of medication information in the medical records, discrepancies between medications noted on the BPMDL and those prescribed on the discharge order, and the value of the BPMDL for stakeholders. Results Thirty patients were included in the study. Only 4 % of medical records contained a discharge summary with complete medication information. In 67 % of cases, treatment discontinuations at admission were justified, and medications were reintroduced before discharge, while 107 treatments (45 %) were added but not prescribed on discharge orders. Discontinuations prior to discharge were justified in 60 % of cases (treatments were ended or supportive treatment was required during hospitalization). An average of 2.1 treatments were prescribed on discharge orders (vs. 9.4 prescribed on the BPMDL). Patients, general practitioners (GP), and physicians in long-term care settings (PLTCS) rated the format, content, and readability of the BPMDL as satisfactory, and it was found to be of value for patients and PLTCS to support medication information. Because of the very low response rate among GP (10 %), we were unable to determine their satisfaction with the MedRec discharge process. Conclusion The transmission of patient medication information at discharge is often lacking. As such, the BPMDL appears to have value to both patients and community health providers. Because this study was conducted within a single surgical unit, further study in other surgical wards is needed to assess generalizability.

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Section: Discussionmentioning

confidence: 92%