Emergency Department Clinical Trial
Official title:
Electronic Patient Triage Development and Implementation Involving Nurse (RN), Pharmacy Technician (CPhT), and Pharmacist (RPh) Obtained Medication Histories in the Emergency Department (ED)and Impact on Medication Reconciliation
Up to 50% of medication errors and 20% of adverse drug reactions (ADRs) in the hospital
setting are estimated to be related to communication issues regarding patient medications at
various transition points of care from admission to discharge. The Joint Commission (TJC)
requires accurate and complete medication reconciliation occur at each transition point
throughout hospitalization. Evidence from NQF demonstrates pharmacists (RPh) are the most
effective medication management team leaders in the implementation of medication management
practices and design of medication error reduction strategies; medication reconciliation is
one of the five safety objectives pharmacists are recommended to lead. In addition, the
Massachusetts Coalition for the Prevention of Medical Errors states strong evidence supports
the use of pharmacy technicians (CPhT) in conjunction with pharmacists in completing
accurate medication histories.
WMC nurses (RN) currently are involved in the medication reconciliation process. In 2009, a
Medication Use Evaluation (MUE) of Medication Reconciliation Accuracy found a 67% medication
error rate on admission determined by comparing the nurse-obtained medication history to the
pharmacist-obtained medication history. The number of home medications identified by the
pharmacist compared to the nurse was 411 versus 312 (p<0.0001). The total percentage of
medication errors prevented by the pharmacist was 66.2. Using the VA Healthcare Failure Mode
Effects Analysis - HFMEAâ„¢ Hazard Scoring Matrix, 3 independent pharmacist reviewers found
that 18% of patients interviewed had a score greater than 7, and 3 patients had a score of
12 (major/probable), if the discrepancies would not have been identified and corrected by
the pharmacist conducting the admission medication reconciliation audit. The same patients'
discharge medication reconciliation and discharge medication lists were retrospectively
reviewed for the MUE, and the total percentage of patients with medication errors on
discharge was 43%.
n/a
Intervention Model: Single Group Assignment, Masking: Single Blind (Caregiver), Primary Purpose: Health Services Research
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