Pharmacy-controlled documentation of drug allergies

Area of Science:

• Pharmacy Practice
• Patient Safety
• Health Informatics

Background:

• Inadequate drug allergy documentation poses a significant patient safety risk.
• Previous audits revealed poor allergy documentation rates across physicians, nurses, and pharmacy profiles.
• Two severe allergic reactions prompted an investigation into existing documentation practices.

Purpose of the Study:

• To describe the implementation of a pharmacy-enforced drug allergy documentation policy.
• To evaluate the effectiveness of the new policy in improving allergy information accuracy and completeness.

Main Methods:

• Implemented a policy requiring physicians to document allergies on initial drug orders.
• Nurses were tasked with independently verifying allergy information.
• Pharmacists were responsible for entering allergy data into patient profiles, with non-dispensing for incomplete records.
• Audits were conducted pre-implementation and at two months and one year post-implementation.

Main Results:

• Significant improvements in allergy documentation completeness and accuracy were observed for pharmacists and physicians post-policy implementation.
• Pharmacy computerized drug profiles showed a marked increase in allergy information.
• Documentation by nurses did not improve to the same extent as physicians and pharmacists.

Conclusions:

• A pharmacy-enforced policy prioritizing allergy documentation before drug dispensing is effective.
• Pharmacist responsibility significantly enhances the accuracy and completeness of drug allergy records.
• Further strategies may be needed to improve nursing documentation of drug allergies.