Document Detail


The national inpatient medication chart: critical audit of design and performance at a tertiary hospital.
MedLine Citation:
PMID:  18205582     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To compare the national inpatient medication chart (NIMC) with the chart previously used at Royal Perth Hospital (RPH) in Western Australia, and with charts used at 13 other hospitals across Australia; and to audit NIMC performance in practice and to assess its design characteristics. DESIGN: Audit of patient prescribing documents extended to include a comparison with aggregated pilot study data and the previous RPH chart. Assessment of design features by inspection, based on their likely effect on medication safety. SETTING: A tertiary public hospital. MAIN OUTCOME MEASURES: Compliance with the requirements of chart fields, measured as the percentage of correct entries according to predetermined criteria as required by the WA Office of Safety and Quality in Health Care. RESULTS: Average compliance was 56% (95% CI, 43%-67%). Differences in compliance after introduction of the NIMC were variable and only one was classified as "major". The number of charts required per admission increased from 3.1 for the previous RPH chart to 6.3 for the NIMC, and chart replacement was required after 2.9 days for the NIMC compared with 5.5 days for the previous RPH chart. Of seven advantages of the NIMC claimed by the WA Director General of Health in a letter to doctors, five (71%) were not confirmed in practice. Ten notable design features of the NIMC with a potential adverse influence on medication safety were identified. CONCLUSIONS: The NIMC contains adverse design features and is inferior to the medication chart previously in use at RPH. The purported advantages of introducing a national standard chart were not experienced at RPH.
Authors:
J Alasdair Millar; Robyn C Silla; Glenda E Lee; Ann Berwick
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  188     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-21     Completed Date:  2008-03-28     Revised Date:  2008-07-31    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  95-9     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Royal Perth Hospital, Perth, WA, Australia. alasdair.millar@health.wa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Australia
Forms and Records Control / standards*
Hospitalization
Humans
Medical Audit
Medication Errors / prevention & control*
Process Assessment (Health Care)*
Quality Assurance, Health Care
Comments/Corrections
Comment In:
Med J Aust. 2008 Jun 16;188(12):732-3; author reply 733   [PMID:  18558901 ]
Erratum In:
Med J Aust. 2008 Apr 7;188(7):432

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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