Impact of clinical pharmacy interventions on medication error nodes
- 824 Downloads
Background Pharmacists’ involvement in patient care has improved the quality of care and reduced medication errors. However, this has required a lot of work that could not have been accomplished without documentation of interventions. Several means of documenting errors have been proposed in the literature but without a consistent comprehensive process. Recently, the American College of Clinical Pharmacy (ACCP) recognized that pharmacy practice lacks a consistent process for direct patient care and discussed several options for a pharmaceutical care plan, essentially encompassing medication therapy assessment, development and implementation of a pharmaceutical care plan and finally evaluation of the outcome. Therefore, as per the recommendations of ACCP, we sought to retrospectively analyze interventions by grouping them according to medication related problems (MRP) and their nodes such as prescribing; administering; monitoring; documenting and dispensing. Objective The aim of this study is to report interventions according to medication error (ME) nodes and show the impact of pharmacy interventions in reducing MRPs. Setting The study was conducted at the cardiology and infectious diseases services at a teaching hospital located in Beirut, Lebanon. Methods Intervention documentation was completed by pharmacy students on infectious diseases and cardiology rotations then reviewed by clinical pharmacists with respective specialties. Before data analysis, a new pharmacy reporting sheet was developed in order to link interventions according to MRP. Then, MRPs were grouped in the five ME nodes. During the documentation process, whether MRP had reached the patient or not may have not been reported which prevented the classification to the corresponding medication error nodes as ME. Main outcome Reduction in medication related problems across all ME nodes. Results A total of n = 1174 interventions were documented. N = 1091 interventions were classified as MRPs. Interventions were analyzed per 1000 patient days and resulted in 340 medication related problem/1000 patient days. A 72 % reduction in MRP across all ME nodes was seen. The majority of interventions were in the field of cardiology followed by infectious disease related. When interventions per ME nodes were analyzed, a high percentage of intervention acceptance was noted across all nodes especially prescribing (68.30 %) monitoring (77.7 %) and in documenting errors (79.36 %). Conclusion The role of pharmacists in reducing preventable MRPs can be shown when pharmacy interventions are analyzed according to corresponding MRP and ME nodes.
KeywordsInterventions Lebanon Medication errors Medication related problems Medication error node Pharmacy Pharmacist
Conflicts of interest
- 2.Aspden P, Wolcott J, Bootman JL, Cronenwett LR, editors. Committee on identifying and preventing medication errors: preventing medication errors: quality chasm series. Washington, DC: The National Academies Press; 2007. ISBN 978-0-309-10147-9.Google Scholar
- 4.Kuo GM, Touchette DR, Marinac JS. Drug errors and related interventions reported by United States clinical pharmacists: the American College of Clinical Pharmacy practiced based research network medication error detection, amelioration and prevention study. Pharmacotherapy. 2013;33(3):253–65.CrossRefPubMedGoogle Scholar
- 5.Crisp GD, Burkhart JI, Esserman DA, Weinberger M, Roth MT. Development and testing of a tool for assessing and resolving medication-related problems in older adults in an ambulatory care setting: the individualized medication assessment and planning (iMAP) tool. Am J Geriatr Pharmacother. 2011;9(6):451–60. doi: 10.1016/j.amjopharm.2011.10.003.CrossRefPubMedPubMedCentralGoogle Scholar
- 9.Accreditation Counsel for Pharmacy Education [Internet]. Accreditation Counsel for Pharmacy Education accreditation standards and key elements for the professional program in pharmacy leading to the doctor of pharmacy degree (Standards 2016). 2 2015 February 2 [cited June 1 2016]. https://www.acpe-accredit.org/pdf/Standards2016FINAL.pdf.
- 11.National Coordinating Council for Medication Error Reporting and Prevention [Internet]. NCC MERP taxonomy of medication errors. 2001 July 31 [cited June 1 2016]. http://www.nccmerp.org/sites/default/files/taxonomy2001-07-31.pdf.
- 12.National Coordinating Council for Medication Error Reporting and Prevention [Internet]. NCC MERP Index for categorizing medication errors 2001 June 12 [cited June 1 2016]. http://www.nccmerp.org/sites/default/files/indexBW2001-06-12.pdf.
- 24.Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Washington, DC: National Academies Press; 1999. ISBN 9780309068376.Google Scholar