Project summary in plain language

The patient in the emergency room

An interprofessional project about medication reconciliation on the admission ward (“Notaufnahmestation”, NAS)

 

Problem/patient group

Accurate documentation of patients’ admission medication is essential to ensure optimal therapy during hospitalization. However, documentation errors are common during transition of care. Patients admitted via the emergency department are particularly susceptible to these errors. Pharmaceutical medication reconciliation is a valuable tool to minimize documentation errors and increase medication safety.

Aim

In this project, a pharmacist conducted a supplementary pharmaceutical medication reconciliation in an emergency admission ward. The aim is to investigate documentation errors in the emergency department regarding admission medication and to optimize its recording. Additionally, risk factors associated with incorrect documentation will be identified.

Implementation

In two observational studies, the medication documented in the pharmaceutical medication reconciliation is compared with the admission medication of the emergency department. The retrospective REAMINAS study examines the discrepancies discovered through this comparison in more detail. In addition, it investigates whether the discrepancies can also be found in the discharge letter. The prospective AMINAS study identifies risk factors that are associated with discrepancies.

Result

The REAMINAS study includes 256 patients. A median of five drugs were documented in the pharmaceutical medication reconciliation and a median of two discrepancies were identified between the admission medication of the emergency department and the pharmaceutical medication reconciliation. By far the most common discrepancy was the omission of a drug (60%). The AMINAS study includes 379 patients. The detailed evaluation is currently ongoing.

Patient benefit

The high number of detected discrepancies shows that pharmaceutical medication reconciliation can significantly improve the recording of admission medication. Analysis of the discrepancies at drug level will provide indications as to which drugs should be given special attention during documentation. Identifying risk factors for incorrect documentation of admission medication enables the targeted use of pharmaceutical resources for critical patients. This can improve hospital treatment and reduce adverse drug effects.

 

 

Image source: Ludwig vom Hofe