Ms Sarah Fussell1,2, Mr Eamonn Butler1, A/Prof Matthew Roberts1
1Eastern Health, Box Hill, Australia, 2University of Tasmania, Hobart, Australia
Aim: To determine if pharmacist-led partnered prescribing (PPP) on discharge reduced errors in documentation of medications in the discharge prescription and the discharge summary of people with kidney disease compared to medical prescribing (MP).
Background: Inaccurate medication documentation on discharge produces poorer patient outcomes and is costly to the healthcare system. Affected patients are 2.3 times more likely to be readmitted to hospital compared with those patients who have an accurate discharge summary.
Methods: This Interventional 2-phase study compared current workflow (MP) with the subsequent implementation of the interventional workflow (PPP). Patients were included if they were hospital inpatients discharged from the renal unit within pharmacy working hours and had a discharge prescription and discharge summary.
An error in documentation was defined as documentation (or no documentation) of a medication not in agreement with the documented treatment plan (for the discharge prescription) or the final, pharmacist reviewed discharge prescription (for the discharge summary).
Results: Data was collected from 185 discharged patients (95 in MP phase then 90 in PPP phase). Discharge prescriptions with at least one error reduced from 75.8% in the MP phase to 6.7% in PPP phase (P<0.001). Discharge summaries with at least one error reduced from 53% in MP phase to 24% in PPP phase (P<0.001). Improvements in electronic medical record workflow has the potential to further reduce these errors to 48% and 3% respectively. The most common error in both phases of the discharge prescription and discharge summary was omitted medication, with the most erroneous medications being paracetamol, vitamin D medications and erythropoiesis stimulating agents.
Conclusion: PPP reduces errors in the documentation of discharge medications of patients with kidney disease.
Biography:
Sarah Fussell is a Senior Clinical Pharmacist at Eastern Health in Melbourne, Australia. She has a special interest in pharmacist involvement in the interdisciplinary care of patients together with effective use of healthcare resources to achieve the best clinical outcome for patients. Sarah has worked in Pharmacy in Australia and in the United Kingdom and utilises her experience in both countries to progress medication management in the hospital setting.