| Medication reconciliation during internal hospital transfer and impact of computerized prescriber order entry. | |
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MedLine Citation:
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PMID: 21098753 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Internal hospital transfer is a vulnerable time during which patients are at high risk of medication discrepancies that can result in clinically significant harm, medication errors, and adverse drug events. OBJECTIVE: To identify, characterize, and assess the clinical impact of unintentional medication discrepancies during internal hospital transfer and to investigate the influence of computerized prescriber order entry (CPOE) on medication discrepancies. METHODS: All patients transferred between 10 inpatient units at 2 tertiary care hospitals were prospectively assessed to identify discrepancies. Interfaces included transfers between (1) units that both used paper-based medication ordering systems; (2) units that both used CPOE-based systems; and (3) units that used both paper-based and CPOE-based systems (hybrid transfer). The primary endpoint was the number of patients with at least 1 unintentional medication discrepancy during internal hospital transfer. Discrepancies were identified through assessment and comparison of a best possible medication transfer list with the actual transfer orders. A multidisciplinary team of clinicians assessed the potential clinical impact and severity of unintentional discrepancies. RESULTS: Overall, 190 patients were screened and 129 patients were included. Eighty patients (62.0%) had at least 1 unintentional medication discrepancy at the time of transfer, and the most common discrepancy was medication omission (55.6%). Factors that independently increased the risk of a patient experiencing at least 1 unintentional discrepancy included lack of best possible medication history, increasing number of home medications, and increasing number of transfer medications. Forty-seven patients (36.4%) had at least 1 unintentional discrepancy with the potential to cause discomfort and/or clinical deterioration. The risk of discrepancies was present regardless of the medication-ordering system (paper, CPOE, or hybrid). CONCLUSIONS: Clinically significant medication discrepancies occur commonly during internal hospital transfer. A structured, collaborative, and clearly defined medication reconciliation process is needed to prevent internal transfer discrepancies and patient harm. |
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Authors:
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Justin Y Lee; Kori Leblanc; Olavo A Fernandes; Jin-Hyeun Huh; Gary G Wong; Bassem Hamandi; Neil M Lazar; Dante Morra; Jana M Bajcar; Jennifer Harrison |
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Publication Detail:
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Type: Journal Article Date: 2010-11-23 |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 44 ISSN: 1542-6270 ISO Abbreviation: Ann Pharmacother Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1887-95 Citation Subset: IM |
Affiliation:
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Toronto General Hospital, University Health Network, Toronto, Ontario, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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