2.50
Hdl Handle:
http://hdl.handle.net/10755/155898
Type:
Presentation
Title:
Post-Hospital Medication Discrepancies: The Safe Care Gap
Abstract:
Post-Hospital Medication Discrepancies: The Safe Care Gap
Conference Sponsor:Sigma Theta Tau International
Conference Year:2011
Author:Costa, Linda, PhD, RN
P.I. Institution Name:The Johns Hopkins Hospital, Johns Hopkins University School of Nursing
Title:Nurse Researcher, Assistant Professor
Co-Authors:Stephanie S. Poe DNP, RN, Coordinator, Nursing Clinical Quality, Director Nursing Informatics
Mei Ching Lee MS, BSN, Senior Research Nurse Project Director
[22nd International Nursing Research Congress - Research Presentation] Purpose: Transition from acute hospitalization to home is a time when the care needs of inpatients are transferred from an expert health care team to the individual and family.  Little is known about the time between hospital discharge and the primary care visit. This research study tested if a hospital-based nurse coaching intervention with patients discharged on complex medication regimens could detect and resolve post-discharge medication discrepancies.
 Methods:  This non-experimental pilot study enrolled adult medicine patients on four or more prescription medications. The intervention included:  1) Hospital interview and medication reconciliation ; 2) 48-hour post-discharge telephone call with structured interview and medication reconciliation; (3) Home visit within 14-days of discharge to observe medication use in the home and disease symptoms; and Telephone follow-up at 30 days to assess discrepancy resolution. A pharmacist was available for consultation. Results: Of the 72 patients approached, 32 entered the study: 100 percent were emergency admissions, 87 percent were female; 94 percent were African-American; and 50 percent were under 65 years old. An average of 10.6 +4.1 medications were prescribed at discharge. Medication discrepancies were found in 67 percent of participants either by telephone interview or home visit.  The nurses identified 36 medication discrepancies during home visits. In 10 of 16 (62.5%) patients, the nurses found medication discrepancies in the home that were not detected by telephone interview. Medication omission was the most common discrepancy. Understanding daily routines of patients and families assisted nurses direct the coaching intervention. Open dialogue was used to focus on what was working well in managing their health.  This approach allowed assessment of potential areas for improvement. Conclusion: Dialogue in the home rather than telephone interview of chronically-ill patients yielded a cooperative environment allowing patients and families to ask openly for information needed to improve self-management and resolve medication discrepancies.
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.titlePost-Hospital Medication Discrepancies: The Safe Care Gapen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155898-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Post-Hospital Medication Discrepancies: The Safe Care Gap</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">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Costa, Linda, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Johns Hopkins Hospital, Johns Hopkins University School of Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Researcher, Assistant Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">lcosta5@jhmi.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Stephanie S. Poe DNP, RN, Coordinator, Nursing Clinical Quality, Director Nursing Informatics<br/>Mei Ching Lee MS, BSN, Senior Research Nurse Project Director</td></tr><tr><td colspan="2" class="item-abstract">[22nd International Nursing Research Congress - Research Presentation] Purpose:&nbsp;Transition from acute hospitalization to home is a time when the care needs of inpatients are transferred from an expert health care team to the individual and family.&nbsp; Little is known about the time between hospital discharge and the primary care visit. This research study tested if a hospital-based nurse coaching intervention with patients discharged on complex medication regimens could detect and resolve post-discharge medication discrepancies. <br/>&nbsp;Methods:&nbsp;&nbsp;This non-experimental pilot study enrolled adult medicine patients on four or more prescription medications. The intervention included:&nbsp; 1) Hospital interview and medication reconciliation ; 2) 48-hour post-discharge telephone call with structured interview and medication reconciliation; (3) Home visit within 14-days of discharge to observe medication use in the home and disease symptoms; and Telephone follow-up at 30 days to assess discrepancy resolution. A pharmacist was available for consultation. Results:&nbsp;Of the 72 patients approached, 32 entered the study: 100 percent were emergency admissions, 87 percent were female; 94 percent were African-American; and 50 percent were under 65 years old. An average of 10.6 +4.1 medications were prescribed at discharge. Medication discrepancies were found in 67 percent of participants either by telephone interview or home visit.&nbsp; The nurses identified 36 medication discrepancies during home visits. In 10 of 16 (62.5%) patients, the nurses found medication discrepancies in the home that were not detected by telephone interview. Medication omission was the most common discrepancy. Understanding daily routines of patients and families assisted nurses direct the coaching intervention. Open dialogue was used to focus on what was working well in managing their health.&nbsp; This approach allowed assessment of potential areas for improvement. Conclusion:&nbsp;Dialogue in the home rather than telephone interview of chronically-ill patients yielded a cooperative environment allowing patients and families to ask openly for information needed to improve self-management and resolve medication discrepancies.</td></tr></table>en_GB
dc.date.available2011-10-26T14:15:42Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T14:15:42Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.