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How often do physicians review medication charts on ward rounds?
1Dept of Pharmacology & Clinical Pharmacology, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. khangli@hotmail.com
Background:
Prescribing errors are common in hospital settings. Regular review of medication charts is recommended as a way to reduce errors but it is not clear how often this happens. The aim of this study was to determine the frequency with which specialist physicians reviewed medication charts during ward rounds.
Methods:
An observer noted how often consultant physicians at Auckland City Hospital reviewed medication charts during ward rounds. The physicians were not aware that they were being observed.
Results:
Twenty-one physicians were observed over a 26 week period. The general physicians reviewed the medication charts on 77% of occasions (range: 45% - 100%) during routine ward rounds and 65% of the time (range: 41% - 80%) on post admission rounds. Subspecialty physicians who did not see more than 8 patients on their rounds reviewed medication charts more frequently (88%) than those specialties where more than 8 patients were seen on average (61%).
Conclusion:
The physicians did not review medication charts on all ward rounds and there was considerable variation in how often they did this. There is some evidence that the frequency with which charts are reviewed decreases as the number of patients seen increases. More efforts should be made to encourage regular review of medication charts.
Insights
Physician medication chart review during ward rounds is inconsistent. General physicians reviewed charts 77% of the time, but frequency decreased with more patients seen, highlighting a need for improved medication safety practices.
Area of Science:
- Medical quality and safety
- Hospital medicine
- Pharmacovigilance
Background:
- Prescribing errors are a significant concern in hospitals.
- Regular medication chart review is advised for error reduction.
- The actual frequency of chart review during ward rounds is not well-documented.
Purpose of the Study:
- To quantify the frequency of medication chart review by specialist physicians during hospital ward rounds.
- To identify factors influencing medication chart review practices.
Main Methods:
- An observational study was conducted at Auckland City Hospital.
- Consultant physicians' medication chart review during ward rounds was unobtrusively observed.
- Data collected over a 26-week period from 21 physicians.
Main Results:
- General physicians reviewed medication charts in 77% of routine ward rounds and 65% of post-admission rounds.
- Subspecialty physicians reviewing fewer than 8 patients reviewed charts more frequently (88%) compared to those seeing more patients (61%).
- Significant variation in review frequency was noted among physicians.
Conclusions:
- Medication charts are not reviewed during every ward round.
- Increased patient load appears to correlate with decreased chart review frequency.
- Enhanced strategies are needed to promote consistent medication chart review for improved patient safety.
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