Medication incidents associated with hospital discharge
Canadian Pharmacists Conference ePoster Library. Ho C. Jun 25, 2016; 132154
Dr. Certina Ho
Dr. Certina Ho
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Abstract
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OBJECTIVES: Hospital discharge is a form of transitional patient care that involves multi-step processes with multiple healthcare professionals at different levels of care. Due to its innate complexity, this process places patients at high risk for medication errors and potential subsequent hospital readmissions. This project examines common themes that are prevalent in medication incidents associated with hospital discharge, and provides insight into system-based recommendations for advancing safe medication practices.,METHODS: Incidents were extracted from the ISMP Canada's Community Pharmacy Incident Reporting (CPhIR) Program between April 2010 and December 2014. A total of 83 incidents met the inclusion criteria. These incidents were analyzed and reviewed by two analysts independently.,RESULTS: A qualitative, multi-incident analysis revealed three main themes underlying these medication incidents: (1) error on the discharge prescription, (2) communication issues, and (3) community integration. Error on the discharge prescription involved preparation errors in the hospital such as inappropriate medications being ordered, inadvertent omission of medications, dosing errors, and wrong patient name on discharge prescriptions. Communication issues referred to miscommunication incidents between the hospital and community that involved illegible writing/print on faxed and written discharge prescriptions, as well as complex medication orders. Finally, community integration explored the lack of continuity between hospital and community care that facilitated medication errors. This included issues such as duplication in medication therapy, different preparations used in the hospital compared to community, and interruptions/additions to multi-medication compliance aids. Medication reconciliation is an effective strategy that can empower community pharmacists to mitigate patient harm and enhance transitional care during hospital discharge.,CONCLUSIONS: Patients discharged from hospitals will continue to experience harm from medication incidents if system-based vulnerabilities are not addressed properly. The results of this multi-incident analysis, along with further investigations, will help develop or improve seamless and comprehensive transitional care practices.
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