Errors in antibiotic transitions between hospital and nursing home: How often do they occur?

Area of Science:

• Pharmacology
• Healthcare Management
• Patient Safety

Background:

• Effective transitions of care are crucial for patient outcomes, especially for those requiring complex medication regimens like antibiotics.
• Inconsistent care during hospital discharge to nursing homes can lead to adverse events and treatment failures.
• Antibiotic stewardship is a growing concern in healthcare settings.

Purpose of the Study:

• To systematically review the fidelity of care transitions for patients discharged from hospital to nursing homes on antibiotic therapy.
• To identify the frequency of inappropriate changes in antibiotic plans during these transitions.

Main Methods:

• Systematic review of 40 paired hospital and nursing home charts from a clinical trial.
• Analysis focused on patients discharged with an active antibiotic prescription.
• Evaluation of documented changes to the antibiotic plan of care during the transition.

Main Results:

• Thirty percent (30%) of the reviewed care transitions included an inappropriate modification to the patient's antibiotic regimen.
• This highlights a significant gap in the continuity and appropriateness of antibiotic management post-discharge.
• Specific types of inappropriate changes were noted, impacting treatment efficacy and potentially contributing to antimicrobial resistance.

Conclusions:

• A substantial proportion of care transitions involving antibiotic therapy are suboptimal.
• Inappropriate changes to antibiotic plans during hospital-to-nursing home transitions pose a risk to patient safety and effective treatment.
• Interventions are needed to improve communication and adherence to antibiotic plans during care transitions.