Medication errors in emergency department by spanish consensus of medication reconciliation
Keywords:
Erros de medicação, Segurança do paciente, Conciliação de medicamentos, Atenção farmacêutica.Abstract
Objective: To describe and quantify unjustified discrepancies (UD) of the last patient’s prescription in the Emergency Department (ED) and establish the average reconciliation time in clinical practice under The Reconciliation Consensus of Medications in the Emergency Department (RCMED).
Methods: Observational, descriptive study. Patients admitted to an Internal Medicine Unit from ED from March to May 2013 were included. The clinical pharmacist obtained by interview with the patient “the best possible medication history" that compared with prescriptions in the ED and recorded the UD. The average reconciliation time for the drug groups established in RCMED was calculated: Group 1, drugs to be reconciliated within four hours; Group 2, drugs to be reconciliated within 24 hours.
Results: 107 UD (62.3%) were reported in 84.3% of patients (n = 43). Fifteen of them (14%) occurred in Group 1 drugs and 92 (86%) in Group 2 drugs. The 63.5% of UD reached the patient without damage and 32.7% reached the patient and may have resulted in temporary harm. The average reconciliation time was 34.3 (± 17.1) hours for drugs in Group 1 and 36.1 (± 21.2) hours for drugs in Group 2.
Conclusions: The high number of UD, the potential seriousness of them and the lack of compliance with the recommended reconciliation time represents a significant opportunity for improvement in the medication reconciliation process in the ED.
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