Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)

NCT01065675 | Terminated

• 1 other identifier: 09-068
• Study Type: interventional
• Target: 153
• Locations: 1 country
• Sites: 1

Brief Summary

Up to 50% of medication errors and 20% of adverse drug reactions (ADRs) in the hospital setting are estimated to be related to communication issues regarding patient medications at various transition points of care from admission to discharge. The Joint Commission (TJC) requires accurate and complete medication reconciliation occur at each transition point throughout hospitalization. Evidence from NQF demonstrates pharmacists (RPh) are the most effective medication management team leaders in the implementation of medication management practices and design of medication error reduction strategies; medication reconciliation is one of the five safety objectives pharmacists are recommended to lead. In addition, the Massachusetts Coalition for the Prevention of Medical Errors states strong evidence supports the use of pharmacy technicians (CPhT) in conjunction with pharmacists in completing accurate medication histories. WMC nurses (RN) currently are involved in the medication reconciliation process. In 2009, a Medication Use Evaluation (MUE) of Medication Reconciliation Accuracy found a 67% medication error rate on admission determined by comparing the nurse-obtained medication history to the pharmacist-obtained medication history. The number of home medications identified by the pharmacist compared to the nurse was 411 versus 312 (p\<0.0001). The total percentage of medication errors prevented by the pharmacist was 66.2. Using the VA Healthcare Failure Mode Effects Analysis - HFMEA™ Hazard Scoring Matrix, 3 independent pharmacist reviewers found that 18% of patients interviewed had a score greater than 7, and 3 patients had a score of 12 (major/probable), if the discrepancies would not have been identified and corrected by the pharmacist conducting the admission medication reconciliation audit. The same patients' discharge medication reconciliation and discharge medication lists were retrospectively reviewed for the MUE, and the total percentage of patients with medication errors on discharge was 43%.

Conditions

Medication Reconciliation; Emergency Department

Keywords

Medication Reconciliation; Emergency Department; Nurse; Pharmacist; Certified Pharmacy Technician; Medication reconciliation: inpatients admitted from the ED

Outcome Measures

Primary Outcomes (1)

• To determine which patients benefit most from medication histories obtained by the RN, CPhT, or RPh based on accuracy (% complete disease states, allergy documentation and description, vaccination documentation, medication documentation)

  5 months

Interventions

Medication reconciliation completed by a RN, CPhT, or RPh OTHER

To determine which patients benefit the most from medication histories obtained by the RN, CPhT, or RPh. Patients will be admitted as inpatients through the ED with medication histories finalized electronically by the RN at the admitting unit.

Also known as: Medication Reconciliation, Pharmacist, Nurse, Certified Pharmacy Technician, Emergency Department, ED

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients admitted as inpatients from the Emergency Department

You may not qualify if:

• Prisoners (because the IRB does not have a prisoner representative)
• Patients not admitted as inpatients through the Emergency Department
• Patients admitted more than once during the study period

Sponsors & Collaborators

• Wesley Medical Center: lead
• Cardinal Health: collaborator

Study Sites (1)

Wesley Medical Center

Wichita, Kansas, 67214, United States

Location

MeSH Terms

Conditions

Emergencies

Interventions

Medication Reconciliation; Pharmacists; Nurses; Emergency Service, Hospital

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Medication Errors; Drug Therapy; Therapeutics; Medical Errors; Health Services; Health Care Facilities Workforce and Services; Medication Systems; Organization and Administration; Health Services Administration; Patient Care Management; Health Personnel; Hospital Departments; Hospital Administration; Health Facility Administration; Health Facilities; Emergency Medical Services

Study Officials

• Joan S Kramer, PharmD

  Wesley Medical Center

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Research Pharmacist

Study Record Dates

• First Submitted: February 3, 2010
• First Posted: February 9, 2010
• Study Start: February 1, 2010
• Primary Completion: April 1, 2010
• Study Completion: May 1, 2011
• Last Updated: December 28, 2012

Record last verified: 2012-12

Locations

US (1)