18. Effect of standardized catheterization lab order forms on peri-procedural prescription errors, patient care and staff satisfaction

Abstract

Medication errors are the most common cause of iatrogenic adverse events. They can lead to severe complications, including prolonged hospitalization, unnecessary diagnostic tests and treatments, and even death. Objective: We set to explore the impact of introducing standardized cath lab order forms on medication errors, quality of patient care and staff satisfaction. This was a single center observational study conducted in a tertiary cardiac center in Saudi Arabia. We enrolled a total of 100 consecutive patients who underwent diagnostic or interventional cardiac catheterization before or after the introduction of standardized order forms. The cohort was divided into two equal groups. We compared medication prescription errors (as defined by hospital formulary) between the two groups. We also studies the impact of the standardized order forms on peri-procedural care including laboratory tests order completion, peri-procedural fluid and diabetes management, anticoagulant, diuretic and analgesia management. We have also employed a structured questionnaire to assess staff satisfaction with the use of these forms implementation of standardized order forms resulted in significant reduction of prescription errors from 32.0% to 0.0% (p = 0.025). There was also a significant improvement in patient care as indicated by improvement in the rates of completion of laboratory orders that improved from 76.0% to 96.0% after the implementation of order forms (p = 0.004), proper fluid management (100% vs. 86.0%, p = 0.023) and better peri-procedural diabetic management (see attached table). There was also improvement in the monitoring of the vascular access site (80% vs. 100%, p = 0.004) that resulted in reduction in access site related complications (6% vs. 0%). We administered a satisfaction questionnaire to 61 participants (nurses, physicians and pharmacists). The mean total satisfaction score was 62.8 for pharmacists, 50.4 for nurses and 48.6 for physicians indicating that the pharmacists were most satisfied with the implementation of these order forms and the physicians were the least satisfied (p = 0.052). Our study shows that standardized order forms have the potential to decrease medication-prescribing errors and improve quality of patient care among patients undergoing diagnostic and interventional cardiac procedures.