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Use of an Anti-Infective Medication Review Process at Hospital Discharge to Identify Medication Errors and Optimize

Christy P Su1, Levita Hidayat2, Shafiqur Rahman3

  • 1Department of Pharmacy, Memorial Hermann Greater Heights Hospital, Houston, TX, USA.

Journal of Pharmacy Practice
|March 15, 2018
PubMed
Abstract

Insights

A structured antimicrobial review process at hospital discharge identified medication errors in 42% of patients. This stewardship program successfully prevented medication errors in 68% of affected patients.

Area of Science:

  • Pharmacy
  • Infectious Diseases
  • Patient Safety

Background:

  • Medication reconciliation is critical for patient safety.
  • Evaluating anti-infective agents during hospital discharge requires structured processes.

Purpose of the Study:

  • To describe a multidisciplinary approach for reviewing anti-infectives at discharge.
  • To measure the impact of antimicrobial stewardship in preventing anti-infective-related medication errors.

Main Methods:

  • A prospective study evaluated adult patients discharged on anti-infectives from October 2013 to May 2014.
  • The antimicrobial stewardship program (ASP) categorized interventions on anti-infective regimens.

Main Results:

  • 45 patients with 59 anti-infective prescriptions were analyzed.
  • Medication errors (MEs) were found in 42% of anti-infective regimens.
  • ASP recommendations were accepted in 70% of cases, preventing MEs in 68% of affected patients.

Conclusions:

  • A stewardship-initiated review process effectively prevents medication errors at hospital discharge.
  • A systematic, multidisciplinary ASP review of anti-infectives is valuable for patient safety.
Keywords:
antimicrobial stewardshiphospital dischargemedication errorsmedication reconciliationtransitions of care

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