Potential Risk of Medication Discrepancies and Reconciliation Errors at Admission and Discharge from an Inpatient Medical Service

Climente‐Martí, Mónica; García-Mañón, Elda R; Artero, Arturo; Jiménez-Torres, N Vfctor

doi:10.1345/aph.1p184

Cited by 90 publications

(84 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our incidence of discharge medication errors is within the 25-71% incidence found in other studies. 4,11,23 Additionally, when we probed a subset of patients who had errors on admission and discharge, we found that the distribution of types of errors (i.e. mostly errors of omission or commission) were similar to prior studies.…”

Section: Discussionsupporting

confidence: 73%

“…1,3,12,14,15,23,25 Several factors we found to be associated with medication reconciliation errors, such as older age and number of preadmission medications, were confirmed by others. 11,12,14,15 However, in one study fewer unintentional medication discrepancies were associated with age over 85 compared to age less than 50. 12 Herrero-Herrero et al found that the number of preadmission medications predicted unjustified discrepancies (i.e.…”

Section: Discussionmentioning

confidence: 92%

“…We did not investigate medication errors from in-hospital transfers nor assess the clinical impact of medication errors, though the relationship between total errors, clinically relevant errors, and ADEs have been described in several prior studies. 3,4,11,12,14,15,22,23,34 Clinically relevant medication errors were classified at the discretion of the pharmacists, thereby introducing possible bias in the judgment of these outcomes. The potential of errors to cause harm was not formally adjudicated by a blinded panel of clinicians.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Subsequently, errors in the pre-admission medication list (PAML) may persist through hospitalization and contribute to discharge medication errors. 11 Little research has examined how patient characteristics and other factors affect the medication reconciliation process-those that have are generally small, single site studies (or two sites within one hospital system). [11][12][13][14][15] Also few studies have examined how errors in the medication history-taking process (PAML errors) affect the likelihood of discharge errors.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effect of Patient- and Medication-Related Factors on Inpatient Medication Reconciliation Errors

et al. 2012

View full text Add to dashboard Cite

BACKGROUND:Little research has examined the incidence, clinical relevance, and predictors of medication reconciliation errors at hospital admission and discharge. OBJECTIVE: To identify patient-and medication-related factors that contribute to pre-admission medication list (PAML) errors and admission order errors, and to test whether such errors persist in the discharge medication list. DESIGN, PARTICIPANTS: We conducted a crosssectional analysis of 423 adults with acute coronary syndromes or acute decompensated heart failure admitted to two academic hospitals who received pharmacistassisted medication reconciliation during the Pharmacist Intervention for Low Literacy in Cardiovascular Disease (PILL-CVD) Study. MAIN MEASURES:Pharmacists assessed the number of total and clinically relevant errors in the PAML and admission and discharge medication orders. We used negative binomial regression and report incidence rate ratios (IRR) of predictors of reconciliation errors. KEY RESULTS: On admission, 174 of 413 patients (42%) had ≥1 PAML error, and 73 (18%) had ≥1 clinically relevant PAML error. At discharge, 158 of 405 patients (39%) had ≥1 discharge medication error, and 126 (31%) had ≥1 clinically relevant discharge medication error. Clinically relevant PAML errors were associated with older age (IRR=1.46; 95% CI, 1.00-2.12) and number of pre-admission medications (IRR=1.17; 95% CI, 1.10-1.25), and were less likely when a recent medication list was present in the electronic medical record (EMR) (IRR=0.54; 95% CI, 0.30-0.96). Clinically relevant admission order errors were also associated with older age and number of pre-admission medications. Clinically relevant discharge medication errors were more likely for every PAML error (IRR=1.31; 95% CI, 1.19-1.45) and number of medications changed prior to discharge (IRR=1.06; 95% CI, 1.01-1.11). CONCLUSIONS: Medication reconciliation errors are common at hospital admission and discharge. Errors in preadmission medication histories are associated with older age and number of medications and lead to more discharge reconciliation errors. A recent medication list in the EMR is protective against medication reconciliation errors.

show abstract

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effect of Patient- and Medication-Related Factors on Inpatient Medication Reconciliation Errors

et al. 2012

View full text Add to dashboard Cite

show abstract

“…20 Correctly documenting all medications on admission cannot be stressed enough, as it will contribute to the patient's safety and outcomes throughout the hospital stay and at discharge. 21,22 Once an accurate medication history is obtained, proper evaluation of these agents is required. An order to continue home medications without critical appraisal of the need to continue each agent is an unacceptable practice.…”

mentioning

confidence: 99%

Health care system vulnerabilities: Understanding the root causes of patient harm

Thompson-Moore

Liebl

2012

American Journal of Health-System Pharmacy

View full text Add to dashboard Cite

Quality collaboratives and campaigns to reduce readmissions: What strategies are hospitals using?

Bradley

Sipsma²,

Curry

et al. 2013

Journal of Hospital Medicine

View full text Add to dashboard Cite

Background Reducing hospital readmissions is a national priority, and many hospitals are participating in quality collaboratives or campaigns. Objective To describe and compare the current use of hospital strategies to reduce readmissions in two prominent quality initiatives – STAAR (the State Action on Avoidable Rehospitalization) and H2H (Hospital-to-Home Campaign). Design Cross-sectional. Methods Web-based survey of hospitals that had enrolled in H2H or STAAR from May 2009 through June 2010, conducted from November 1, 2010 through June 30, 2011 and (n= 599, response rate of 91%). We used standard frequency analysis and multivariable logistic regression to describe differences between STAAR and H2H hospitals. Results Many hospitals were not implementing several of the recommended strategies. Although STAAR hospitals tended to be more likely to implement several strategies, differences were attenuated when we adjusted for region and ownership type. In multivariable models, STAAR hospitals compared with H2H hospitals were more likely to ensure outpatient physicians were alerted within 48 hours of patient discharge (63% versus 38%, P-value < 0.001), and more likely to provide skilled nursing facilities the direct contact number of the inpatient treating physician for patients transferred (53% versus 34%, P-value = 0.001). H2H hospitals were more likely to assign responsibility for medication reconciliation to nurses usually or always (80% versus 54%, P-value = 0.001) and more likely to give most or all discharged patients referrals to cardiac rehabilitation services (59% versus 41%, P-value = 0.001). Conclusions Substantial opportunity for improvement exists for hospitals engaged in STAAR or H2H quality initiatives.

show abstract

Potential Risk of Medication Discrepancies and Reconciliation Errors at Admission and Discharge from an Inpatient Medical Service

Cited by 90 publications

References 21 publications

Effect of Patient- and Medication-Related Factors on Inpatient Medication Reconciliation Errors

Effect of Patient- and Medication-Related Factors on Inpatient Medication Reconciliation Errors

Health care system vulnerabilities: Understanding the root causes of patient harm

Quality collaboratives and campaigns to reduce readmissions: What strategies are hospitals using?

Contact Info

Product

Resources

About