TRIP

Effect of Education on the Recording of Medicines on Admission to Hospital.

Journal of General Internal Medicine, 2010

BACKGROUND: The inaccurate recording of medicines on admission to hospital is an important cause of medication error.
OBJECTIVE: To determine if a multimodal intervention involving medication reconciliation with real-time feedback and education would reduce the number of errors made by medical staff when recording medicines at the time of admission to hospital.
PARTICIPANTS: Patients admitted to the general medical wards of a teaching hospital were studied prospectively.
Patients >/=75 years of age and on >/=5 medications were identified as the 'target group.' INTERVENTION: After admission, a second medication history was taken, and discrepancies were identified and communicated to the medical teams.
An educational intervention to encourage prescribers to obtain accurate medication histories was conducted at the same time.
MAIN RESULTS: There were 470 admissions in the 'target group.' Three hundred and thirty-eight of the admissions (71.9%) had one or more unintentional discrepancies.
Although many discrepancies had little potential to cause harm, 33% were rated as clinically significant.
During the study the discrepancy rate (prior to reconciliation) fell from 2.6 (SD 2.6) to 1.0 (SD 1.1) per admission (p < 0.0001).
This decline in discrepancy rate remained significant (p = 0.001) even when only clinically important discrepancies were included.
The proportion of admissions with one or more clinically important discrepancies also decreased during the study from 46% to 24% (p = 0.023).