OTC

Patient Safety and Quality: An Evidence-Based Handbook for Nurses

Study type/ Setting Methods Outcomes Recommendations Source
Book chapter

 

Setting: Multiple

 

 

Discussed medication reconciliation in different care settings - Ambulatory setting: Miller et al. studies found about 87% of charts had incomplete documentation of medications

- Inpatient: Vira et al. found 38% discrepancy rate for inpatient hospital setting - Transition of care:

Pronovost et al. found 94% discrepancy between discharge orders from ICU to transition of care

Recommendations:

- Identify a standard location where the med history would be reported, an assigned person to document the med history, time frame to resolve the variations, and a standard template to document medication history

- Educate provider as well as patient, caregivers

- Design and implement monitoring process to evaluate the outcome of the process

Barnsteiner, J (2008)
Hughes R. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville, MD: Agency for Healthcare Research and Quality; 2008 pp.459-468.

Medication errors: the importance of an accurate drug history.

Study type/ Setting Methods Outcomes Recommendations Source
Review

 

 

Emphasized the importance of complete medication history from different sources e.g. physicians, pharmacists and case notes that includes allergy, drug interaction, OTC inclusion, common side effects.  - Cited one study where 59 patients out of 101 patients reported the use of 129 forms of CAMs, but only 36 were documented in the medical record Recommended some measures that would provide complete medication list

1.      Pharmacist-led med history taking

2.      Educating newly qualified prescribers on clinical pharmacology, OTC

3.      E-prescribing with pre-populated warning messages

Fitzgerald RJ (2009)
Fitzgerald RJ. Medication errors: the importance of an accurate drug history. British Journal of Clinical Pharmacology. 2009;67(6):671-675. doi:10.1111/j.1365-
2125.2009.03424.x