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Standardizing Medication Reconciliation in a Pediatric Emergency Department.
Sheth, Sarika; Bialostozky, Mario; Hollenbach, Kathy; Heitzman, Lindsay; O'Crump, Deven; Mishra, Seema; Langley, Gregory; Santiago, Kristen; Saleh, Fareed; Billman, Glenn; Bryl, Amy.
Afiliación
  • Sheth S; Rady Children's Hospital San Diego, San Diego, California.
  • Bialostozky M; Department of Pediatrics, University of California-San Diego, San Diego, California.
  • Hollenbach K; Rady Children's Hospital San Diego, San Diego, California.
  • Heitzman L; Department of Pediatrics, University of California-San Diego, San Diego, California.
  • O'Crump D; Rady Children's Hospital San Diego, San Diego, California.
  • Mishra S; Department of Pediatrics, University of California-San Diego, San Diego, California.
  • Langley G; Rady Children's Hospital San Diego, San Diego, California.
  • Santiago K; Rady Children's Hospital San Diego, San Diego, California.
  • Saleh F; Rady Children's Hospital San Diego, San Diego, California.
  • Billman G; Department of Pediatrics, University of California-San Diego, San Diego, California.
  • Bryl A; Rady Children's Hospital San Diego, San Diego, California.
Pediatrics ; 153(2)2024 Jan 01.
Article en En | MEDLINE | ID: mdl-38273780
ABSTRACT

BACKGROUND:

Medication errors are common during transitions of care, such as discharge from the emergency department (ED) or urgent care (UC). The Joint Commission has identified medication reconciliation as a key safety practice. Our aim was to increase the percentage of patients with completed medication reconciliation at discharge from our pediatric ED and 4 UCs from 25% to 75% in 12 months.

METHODS:

Key stakeholders included ED and UC physicians and nurses, informatics, and quality management. The baseline process for medication reconciliation was mapped and modified to create a standard process for nurses and physicians. An Ishikawa diagram was created to assess potential failures. Electronic health record interventions included adapting an inpatient workflow and using a clinical decision support tool. Educational interventions included just-in-time training, physician education via division meeting presentations, video tutorials, and physician-specific and group feedback using funnel plots. The secondary process measure was the proportion of patients discharged from the ED and UCs with completed home medication nursing review. We used statistical process control to analyze changes in measures over time.

RESULTS:

In the UCs, home medication nursing review increased from 91% to 98% and medication reconciliation increased from 35% to 82% within 4 months. In the ED, home medication nursing review increased from 2% to 83% within 8 months and medication reconciliation increased from 26% to 64% within 18 months.

CONCLUSIONS:

We successfully increased the proportion of UC and ED discharged patients with completed medication reconciliation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conciliación de Medicamentos / Errores de Medicación Tipo de estudio: Prognostic_studies Límite: Child / Humans Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Conciliación de Medicamentos / Errores de Medicación Tipo de estudio: Prognostic_studies Límite: Child / Humans Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos