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- Title
Regular Medications in the Emergency Department Short Stay Unit (ReMedIES): Can Prescribing be Improved Without Increasing Resources?
- Authors
Jackson, Aidan B.; Lewis, Mark; Meek, Robert; Kim-Blackmore, Jeniffer; Khan, Irim; Deng, Yong; Vallejo, Jaime; Egerton-Warburton, Diana
- Abstract
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.
- Subjects
MEDICATION error prevention; LENGTH of stay in hospitals; HOSPITAL emergency services; SCIENTIFIC observation; CONFIDENCE intervals; NONPRESCRIPTION drugs; PATIENTS; HOSPITAL admission &; discharge; PRE-tests &; post-tests; HOSPITAL wards; DRUG prescribing; DESCRIPTIVE statistics; QUALITY assurance; PHYSICIAN practice patterns; MEDICAL prescriptions; RESOURCE-limited settings
- Publication
Hospital Pharmacy, 2024, Vol 59, Issue 1, p110
- ISSN
0018-5787
- Publication type
Article
- DOI
10.1177/00185787231194999