Bedside medication lockers: the hidden danger upon discharge

Abstract

Background Bedside medication lockers are widely used in hospitals for storing inpatient and discharge medications; however, there is a risk that inpatient medicines may be inadvertently supplied at discharge. Aim To quantify the extent of inappropriate medications found in bedside medication lockers, in order to develop future strategies to reduce the risk of patients being discharged with inappropriate medications. Methods A pharmacy assistant checked the bedside medication lockers of admitted patients against the current inpatient medication charts twice a week for 2 months in a surgical ward of an Australian tertiary hospital. The pharmacy assistant identified, documented and removed the ceased, non-prescribed and other patient's medications. The hospital reporting system was queried for reports of non-prescribed medicines being sent home at discharge at the end of the study period. Results Over 2 months, 533 of 557 (96%) admitted patients had their bedside medication lockers checked on the designated days. Medications were removed from 101 (19%) of the 533 bedside medication lockers checked. Of the 187 medications removed, 73 (39%) were ceased, 104 (56%) were not current and 10 (5%) were labelled with a different patient name. Review of the hospital reporting system did not identify any reports of surgical patients discharged with inappropriate or unlabelled medicines. Conclusion Checking bedside medication lockers by a pharmacy assistant has highlighted a number of inappropriate medications that could potentially be discharged with the patient if appropriate medication reconciliation does not occur. This area of medication management requires further investigation to determine if this process reduces the risk of medication misadventure on discharge.