Nurse-Led Interdisciplinary Teams: Collaboration on Medication Reconciliation

2.50
Hdl Handle:
http://hdl.handle.net/10755/151053
Type:
Presentation
Title:
Nurse-Led Interdisciplinary Teams: Collaboration on Medication Reconciliation
Abstract:
Nurse-Led Interdisciplinary Teams: Collaboration on Medication Reconciliation
Conference Sponsor:Sigma Theta Tau International
Conference Year:2010
Author:Costa, Linda L., PhD, RN, NEA-BC
P.I. Institution Name:The Johns Hopkins Hospital
Title:Nurse Researcher
21st INRC [Research Presentation] Purpose: In many academic medical centers, various members of the interdisciplinary team obtain medication histories from patients and document their findings on separate tools.ÿ This research study tested a nurse-pharmacist intervention to prevent adverse drug events (ADE) through an enhanced medication reconciliation protocol.ÿ A cost-benefit analysis was conducted to determine the cost of the intervention. Methods: The nurse-pharmacist team conducted medication reconciliation on admission and discharge at a 1,000 bed academic tertiary care hospital.ÿ Study team verified/improved "active" medication list used by the care team. The interview took an average of 10 minutes; accessing additional sources of information took an additional 29 minutes to complete the protocol. The pharmacist was a consultant to the nurses. Potential discrepancies between the home list and admission/discharge orders were discussed with the prescriber and counted as "unintended discrepancies" if the patient's orders were changed. Results: A total of 563 medicine patients entered the study: 87 percent were emergency admissions, 69.5 percent were under 65 years old, and 65 percent were African-American.ÿ The average number of medications taken was 7.76 Mean +/- 4.9 SD. Of the 563 patients, 226 (40%) experienced unintended discrepancies on admission or discharge.ÿ Of those, 162 patients had discrepancies rated as having the potential to cause harm determined by a team of physicians and pharmacists (intra-class correlation 0.58). Logistic regression was used to predict the occurrence of discrepancies, the number of medications was significantly associated with discrepancy. The average intervention cost per patient was $32 with a projected cost of $9300 per ADE prevented.ÿ The intervention would breakeven if one ADE were prevented in 290 patients. Conclusion: A nurse-led protocol to detect and correct unintended discrepancies improved patient safety and the appropriateness of care. Interdisciplinary team interventions to prevent ADEs can reduce health care costs.ÿ
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleNurse-Led Interdisciplinary Teams: Collaboration on Medication Reconciliationen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151053-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Nurse-Led Interdisciplinary Teams: Collaboration on Medication Reconciliation</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Costa, Linda L., PhD, RN, NEA-BC</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Johns Hopkins Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Researcher</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lcosta5@jhmi.edu</td></tr><tr><td colspan="2" class="item-abstract">21st INRC [Research Presentation] Purpose: In many academic medical centers, various members of the interdisciplinary team obtain medication histories from patients and document their findings on separate tools.&yuml; This research study tested a nurse-pharmacist intervention to prevent adverse drug events (ADE) through an enhanced medication reconciliation protocol.&yuml; A cost-benefit analysis was conducted to determine the cost of the intervention. Methods: The nurse-pharmacist team conducted medication reconciliation on admission and discharge at a 1,000 bed academic tertiary care hospital.&yuml; Study team verified/improved &quot;active&quot; medication list used by the care team. The interview took an average of 10 minutes; accessing additional sources of information took an additional 29 minutes to complete the protocol. The pharmacist was a consultant to the nurses. Potential discrepancies between the home list and admission/discharge orders were discussed with the prescriber and counted as &quot;unintended discrepancies&quot; if the patient's orders were changed. Results: A total of 563 medicine patients entered the study: 87 percent were emergency admissions, 69.5 percent were under 65 years old, and 65 percent were African-American.&yuml; The average number of medications taken was 7.76 Mean +/- 4.9 SD. Of the 563 patients, 226 (40%) experienced unintended discrepancies on admission or discharge.&yuml; Of those, 162 patients had discrepancies rated as having the potential to cause harm determined by a team of physicians and pharmacists (intra-class correlation 0.58). Logistic regression was used to predict the occurrence of discrepancies, the number of medications was significantly associated with discrepancy. The average intervention cost per patient was $32 with a projected cost of $9300 per ADE prevented.&yuml; The intervention would breakeven if one ADE were prevented in 290 patients. Conclusion: A nurse-led protocol to detect and correct unintended discrepancies improved patient safety and the appropriateness of care. Interdisciplinary team interventions to prevent ADEs can reduce health care costs.&yuml;</td></tr></table>en_GB
dc.date.available2011-10-26T10:50:30Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T10:50:30Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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