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Improving Timely Administration of Essential Outpatient Medications in a Pediatric ED.
Creedon, Jessica K; Marini, Michelle; Erdner, Kim; Trexler, Megan; Gerling, Megan; Porter, John J; Kent, Caitlin; Capraro, Andrew; Volpe, Diana; Shah, Dhara; Paydar-Darian, Niloufar; Perron, Catherine; Stack, Anne; Hudgins, Joel D.
Afiliación
  • Creedon JK; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Marini M; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Erdner K; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Trexler M; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Gerling M; Quality Department of Colorado Department of Public Health, Denver, Colorado.
  • Porter JJ; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Kent C; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Capraro A; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Volpe D; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Shah D; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Paydar-Darian N; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Perron C; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Stack A; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
  • Hudgins JD; Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Boston.
Pediatrics ; 154(4)2024 Oct 01.
Article en En | MEDLINE | ID: mdl-39238471
ABSTRACT
BACKGROUND AND

OBJECTIVES:

The complexity of pediatric patients' outpatient medication regimens is increasing, and risk for medication errors is compounded in a busy emergency department (ED). As ED length of stay (LOS) increases, timely and accurate administration of essential outpatient medications has become increasingly challenging. Our objective was to increase the frequency of ordering of essential outpatient medications for patients with ED LOS >4 hours from 56% to 80% by June 2023.

METHODS:

We conducted a quality improvement (QI) initiative in a pediatric ED with ∼60 000 annual visits comprising a total of 91 000 annual medication orders. We defined essential outpatient medications as antiepileptic drugs, cardiovascular medications, and immunosuppressants. Our QI interventions included a combination of electronic health record interventions, a triage notification system to identify patients with essential outpatient medications, and widespread educational interventions including trainee orientation and individualized nursing education. The primary outcome measure was percentage of essential outpatient medications ordered among patients with an ED LOS >4 hours, with a secondary measure of outpatient medication safety events.

RESULTS:

Baseline monthly ordering rate of selected medications for patients with an ED LOS >4 hours was 54%, with an increase to 66% over the study period. Refining our population yielded a rate of 81%. Outpatient medication safety events remained unchanged, with an average of 952 ED encounters between events.

CONCLUSIONS:

A multidisciplinary QI initiative led to increased essential outpatient medication ordering for patients in a pediatric ED with no change in safety events.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicio de Urgencia en Hospital / Mejoramiento de la Calidad 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: Servicio de Urgencia en Hospital / Mejoramiento de la Calidad Límite: Child / Humans Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos