Effect of teaching and checklist implementation on accuracy of medication history recording at hospital admission
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Background Medication discrepancies at hospital admission is an extensive problem and knowledge is limited regarding improvement strategies. Objective To investigate the effect of teaching and checklist implementation on accuracy of medication history recording during hospitalization. Method Patients admitted to an internal medicine ward were prospectively included in two consecutive periods. Between the periods, non-mandatory teaching lessons were provided and a checklist assisting medication history recording implemented. Discrepancies between the recorded medications at admission and the patient’s actual drug use, as revealed by pharmacist-conducted medication reconciliation, were compared between the periods. The primary endpoint was difference between the periods in proportion of patients with minimum one discrepancy. Difference in median number of discrepancies was included as a secondary endpoint. Results 56 and 119 patients were included in period 1 (P1) and period 2 (P2), respectively. There was no significant difference in proportion of patients with minimum one discrepancy in P2 (68.9 %) versus P1 (76.8 %, p = 0.36), but a tendency of lower median number of discrepancies was observed in P2 than P1, i.e. 1 and 2, respectively (p = 0.087). Conclusion More powerful strategies than non-mandatory teaching activities and checklist implementation are required to achieve sufficient improvements in medication history recording during hospitalization.
KeywordsMedication discrepancies Medication history recording Medication reconciliation Norway Patient safety Quality improvement
The authors thank participating nurses and physicians for their positive attitude and contribution to the study.
Author ML received PhD funding from the South-Eastern Norway Regional Health Authority.
Conflicts of interest
- 5.World Health Organization (WHO) Collaboration Centre for Drug Statistics Methodology, ATC/DDD Index 2015. [cited 2015 07.01.2015]. http://www.whocc.no/atc_ddd_index/.