IS OUR MED-REC A MED-WRECK? QUALITY IMPROVEMENT STUDY

Abstract

SESSION TITLE: Tuesday Abstract Posters SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/22/2019 01:00 PM - 02:00 PM PURPOSE: To improve patient care during hospitalization and decrease readmission rates. METHODS: This study was performed at Saint Peter’s University Hospital during the months of June- September 2018. Patient charts were randomly identified and reviewed by two physician residents (RC, JJ). Home medications were identified based on information provided by the patient, caregivers, and documents from the PCP’s office and/or patient’s pharmacy. Medication reconciliation was deemed accurate if there was 100% concurrence between the medication intake performed by the admitting staff and the reconciliation performed by the quality improvement team. All data was entered in Microsoft Excel. RESULTS: A total of 40 charts were reviewed in the study period. The mean age was 68±19.6 years, 25 (63.5%) patients were Caucasians, 6 (15%) were African-American, 6 (15%) others and 3 (7.5%) patients refused to answer. 21 males (52.5%). 35 (87.5%) spoke English, while the primary language of others was Spanish (1), Korean (1), Filipino (1), Mandarin (1), Vietnamese (1). 21 were daytime admissions (52.5%) and 19 were nighttime admissions (47.5 %). 25 (62.5%) admission medication reconciliations were accurate, 14 (35%) were inaccurate, and 1 (2.5%) was an outlier. For the daytime admissions, 61.9% were accurate and 38.1% were inaccurate. Of the nighttime admissions, 63.15% were accurate, 31.57% were inaccurate, and 5.26% was an outlier. Of the fifteen charts with a medication reconciliation errors incomplete list (53%), dosing errors (40%) and wrong medication (7%) were the causes of inaccuracy. The main causes for inaccurate medication reconciliation were reliability on patient knowledge of his or her own meds, unreported over-the-counter medications, initial reconciliation performed by different hospital staff (nurses, pharmacist, nurse aids, ED physicians), medications not double checked with pharmacies or primary care physicians, lack of time for patient encounters, and language barriers. CONCLUSIONS: Medication errors exist despite electronic medication reconciliation. Reconciliation errors were equal despite the time of admission. At the end of our study we concluded there should be a person designated for medication reconciliation of the patients admitted into the hospital. CLINICAL IMPLICATIONS: Medication errors are one of the leading causes of injury to hospital patients, and chart reviews reveal that over half of all hospital medication errors occur at different interfaces of care. Medication reconciliation process involves verification, clarification, and reconciliation. We conducted this quality improvement project to identify how accurate is our admission Medication intake process and evaluate the different causes of inaccuracy. DISCLOSURES: No relevant relationships by Rafael Caputi, source=Web Response No relevant relationships by Jose Jimenez Zuluaga, source=Web Response No relevant relationships by Janani Mohan, source=Web Response