Best Possible Medication History in the Emergency Department: DISCUSSION part 2
The limitations of this study included the small sample size (59 patients) and the short duration (data collection over 1 month). In addition, the principal investigator was not blinded. Conversely, all data were reported by means of standard forms that required complete information, which we believe limited the amount of bias introduced. In addition, for each patient, the technician who completed the research to create the preliminary medication list also interviewed the patient. Although this might have created bias in favour of the technician, both the technician and the pharmacist began their interviews with the same information available to them. Moreover, this procedure mimics what actually happens in the emergency department, where the technicians routinely carry out the research to establish the preliminary medication list. Another notable limitation was the daily timeframe of the study: only patients who presented to the emergency department during daytime hours were included, whereas Safer Healthcare Now! audits typically include multiple hospital units and are not limited to daytime shifts.
One strength of this study was the inclusiveness of the sample. Only patients from nursing homes or other hospitals (i.e., patients who had medication administration records) and patients whose medication history had been obtained by a physician or nurse were excluded. As such, the screening process carried out by the technician was based on completely objective criteria.
These results may not be generalizable to all hospital sites. At the authors’ institution, pharmacy technicians have been working in direct patient care areas, such as the emergency department, for several years. This has given them experience and comfort in participating in the multidisciplinary team and communicating with patients. At sites where pharmacy technicians fulfill strictly traditional roles, the technicians will probably require further training and experience before the results obtained in this study can be duplicated. erectalis
There were no statistically significant differences between pharmacists and trained pharmacy technicians in terms of the presence of discrepancies for prescription or over-the-counter drugs or the mean number of discrepancies for each type of medication. Furthermore, the severity of discrepancies was not significantly different between the 2 groups. Both pharmacists and technicians at this institution were significantly superior to the national average for unintentional discrepancies and success index, as reported in the March 2009 Safer Healthcare Now!