Best Possible Medication History in the Emergency Department: RESULTS part 2
An unintentional discrepancy is defined by Safer Healthcare Now! as a medication error that can lead to one or more adverse drug events. The national average for unintentional discrepancies per patient for December 2008 was 0.54, as reported in the March 2009 quarterly report for medication reconciliation. In the current study, the pharmacists had a mean of 0.25 (SD 0.54) unintentional discrepancies per patient, and the technicians had a mean of 0.24 (SD 0.68) unintentional discrepancies per patient. For both groups, the value was significantly lower than the national average for unintentional discrepancies per patient (for pharmacists, t = -4.03, df = 58, p < 0.001, -2 = 0.22; for technicians, t = -3.43, df = 58, p = 0.001, -2 = 0.17).
The success index refers to the total percentage of correct or acceptable orders recorded in a list of medications prepared for the purposes of medication reconciliation. For December 2008, the national average for the success index was 87.48%, as reported in the Safer Healthcare Now! March 2009 quarterly report. In the current study, the mean success index was 95.48% (SD 11.72%) for pharmacists and 97.05% (SD 7.47%) for technicians. For both groups, the value was significantly higher than the national average: for pharmacists, t = 5.02, df = 53,p < 0.001, -2 = 0.32; for technicians, t = 9.08, df = 53, p < 0.001, -2 = 0.61.
On average, the interviews by pharmacists took 9.24 min (SD 4.75 min) to complete, and those by technicians took 7.96 min (SD 4.60). The interviews by technicians were significantly shorter than those by pharmacists (t = 3.24, df = 54, p = 0.002, -2 < 0.16). These times captured the interviews only, not preparation of the preliminary medication list. levitra plus
Pearson correlations showed that older patients were more likely than younger patients to be taking many prescription medications (r = 0.41, n = 59, p = 0.001) and were more likely to have longer interviews with both the pharmacists (r = 0.45, n = 55, p < 0.001) and the technicians (r = 0.47, n = 55, p < 0.001). A higher number of prescription medications was correlated with more discrepancies for prescription medications in BPMHs prepared by technicians (r = 0.32, n = 59, p = 0.01), but this correlation was not statistically significant for the pharmacists (r = 0.22, n = 59, p = 0.09). The relationship between discrepancies for prescription medications and time of enrolment in the study was not statistically significant for either group (r = -0.25, n = 59, p = 0.05 for interviews conducted by pharmacists; r = 0.02, n = 59, p = 0.86 for interviews conducted by technicians).