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Reducing excessive medication administration in hospitalized adults with renal dysfunction
Ira S Nash1, Mary Rojas, Paul Hebert
1Zena and Michael A. Wiener Cardiovascular Institute and the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, Mount Sinai Medical Center, New York, NY 10029, USA. ira.nash@msnyuhealth.org
Summary
Automated medication safety systems significantly reduce excessive drug doses in hospitalized patients with kidney problems. This technology, combined with prescriber feedback, improves patient safety by preventing medication errors.
Area of Science:
- Clinical Pharmacology
- Health Informatics
- Patient Safety
Background:
- Medication errors pose a significant risk to hospitalized patients.
- Inadequate medication dose adjustments for renal insufficiency are a common issue.
Purpose of the Study:
- To evaluate an automated system for detecting excessive medication doses in adult inpatients with renal insufficiency.
- To assess the impact of this system, coupled with prescriber feedback, on reducing medication errors.
Main Methods:
- An automated detection system was implemented alongside a computerized order entry system.
- The system's impact was evaluated in three nursing units using nurse and pharmacist feedback.
- A comparative analysis was conducted against the rest of a tertiary care academic medical center.
Main Results:
- Baseline excessive dosing rate was 23.2% in participating units and 23.6% in the rest of the hospital.
- With nurse feedback, the rate decreased to 17.3%; with pharmacist feedback, it fell to 16.8%.
- Control units showed no significant reduction in excessive dosing rates.
Conclusions:
- Automated detection systems effectively identify excessive medication administration in patients with renal impairment.
- Routine feedback to prescribers, facilitated by automated systems, significantly reduces medication errors and enhances patient safety.