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Quality Improvement Project to Evaluate Discharge Prescriptions in Children With Cystic Fibrosis

Matilde Merino Sanjuán1, Veronica Chorro-Mari2, Chinedu Nwokoro3

  • 1Catedrática de Universidad, Farmacia y Tecnología Farmacéutica, Facultad de Farmacia, Universidad de Valencia, Burjassot, Valencia, Spain.

Pediatric Quality & Safety
|November 21, 2019
PubMed

Insights

Medication errors in Cystic Fibrosis (CF) patients were reduced by improving discharge prescriptions (DPs) through pharmacist review and safety strategies. While quality improved, the target standard for DPs was not fully met.

Area of Science:

  • Pediatric pharmacology
  • Patient safety
  • Health informatics

Background:

  • Cystic Fibrosis (CF) management involves complex pharmaceutical regimens, increasing the risk of medication errors (ME).
  • Discharge prescriptions (DPs) are critical for continuity of care and patient safety in pediatric CF patients.
  • Previous reviews indicated potential deficiencies in DP quality for CF patients.

Purpose of the Study:

  • To enhance the quality of discharge prescriptions (DPs) for pediatric Cystic Fibrosis (CF) patients.
  • To identify and quantify medication errors (ME) in DPs following hospital admissions for intravenous (IV) antibiotics.
  • To implement and evaluate improvement strategies to reduce MEs in DPs.

Main Methods:

  • A longitudinal observational retrospective study followed by a prospective quasi-experimental phase.
  • A Cystic Fibrosis (CF) pharmacist reviewed discharge prescriptions (DPs) using the six rights of medication administration (6R).
  • Quality indicators were calculated, and improvement strategies were implemented based on retrospective findings.

Main Results:

  • The retrospective phase identified 148 MEs (78 committed, 70 omitted); the prospective phase identified 135 MEs (19 committed, 116 omitted).
  • Quality indicators for drug and dose significantly improved post-intervention.
  • The global quality indicator rose from 22% to 41.82%, falling short of the 50% target.

Conclusions:

  • Retrospective review by a CF pharmacist highlighted significant issues in DP quality.
  • Implementation of targeted improvement strategies led to enhanced prescribing practices.
  • Integrating pharmacists into multidisciplinary teams is crucial for improving DP quality and reducing medication errors.

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