Survey of medication documentation at hospital discharge: implications for patient safety and continuity of care

Abstract

Medication discrepancies at the time of hospital discharge are common and can result in error, patient/carer inconvenience or patient harm. Providing accurate medication information to the next care provider is necessary to prevent adverse events. To investigate the quality and consistency of medication details generated for such transfer from an Irish teaching hospital. This was an observational study of 139 cardiology patients admitted over a 3 month period during which a pharmacist prospectively recorded details of medication inconsistencies. A discrepancy in medication documentation at discharge occurred in 10.8% of medication orders, affecting 65.5% of patients. While patient harm was assessed, it was only felt necessary to contact three (2%) patients. The most common inconsistency was drug omission (20.9%). Inaccuracy of medication information at hospital discharge is common and compromises quality of care.