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[Erroneous drug charts--a health hazard?]
Svein Arthur Jensen1, Torbjørn Øien, Geir Jacobsen
1Institutt for samfunnsmedidin, Norges tekniskk-natuevitenskkapelige universitet, Medisinsk teknisk forskningssenter, Trondheim. sajensen@broadpark.no
Background:
For appropriate medical attention to be given to patients in community care it is essential that the drug charts of the community nurse and the general practitioner's patient records correspond.
Material And Methods:
We compared the drug charts for all 38 patients treated by the community nurse in one geographically defined area whose defined general practitioner worked at a health centre in Trondheim, Norway. We calculated total, proportional and chance corrected agreement (Cohen's kappa) for the number of drugs within these records.
Results:
We found that 90% of the drug charts differed by one or more drugs. The general practitioner prescribed 207 drugs of which the patients received only 149, hence 61 prescribed drugs "disappeared". The community nurse administered 201 drugs; this implies that 51 came from other services than the general practitioner. Overall agreement was 53%, chance corrected agreement was kappa = 0.29 (95% confidence interval: 0.12-0.47).
Interpretation:
The number of drugs in the patient records of the community nurse and the general practitioner differ substantially. We find systematic errors in the drug charts and conclude that such errors may be a potential health hazard for the patients.