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1Pharmacy Intern, Department of Pharmacy, Providence St Patrick Hospital, Missoula, Montana.
Introduction:
The role of pharmacists during medication reconciliation (MR) is well established, with a number of reports describing this in the context of psychiatric hospitalizations. However, medication errors (MEs) are common during transitions of care, with no exception during psychiatric hospitalizations. Our institution uses pharmacy-performed MR processes using patient interviews and reviewing objective sources, such as electronic pharmaceutical claims data (EPCD), which includes Medicaid Web portals. The inpatient psychiatric pharmacist reviews EPCD sources against previously pharmacy-completed MRs for new admissions, where if discrepancies are found, the patient is reinterviewed to identify and correct MEs.
Methods:
We performed a prospective quality improvement project during 28 days to evaluate the quantity and classification of MEs upon admission to a 22-bed inpatient psychiatry unit.
Results:
Of 52 included patients, where a cumulative 426 medications were reviewed, a total of 29 MEs in 16 patients were identified. Eight patients had discrepancies on their home medication lists when compared to EPCD, where 7 of these had at least 1 ME due to inaccurate MR.
Discussion:
Of all the MEs identified, the greatest quantity was found secondary to the EPCD "double-check" method. The most common MEs in all patients were the omission of home medications (34%), wrong frequency (28%), and ordering medication the patient is not taking (10%). All patients admitted on long-acting injection antipsychotics had errors in last dose received. No MEs resulted in patient harm, and they were identified and corrected by the psychiatric pharmacist 97% of the time.
Insights
Psychiatric pharmacists identified medication errors (MEs) in 16 of 52 patients during admission medication reconciliation (MR). Most errors involved omissions or incorrect medication frequencies, but pharmacists corrected 97% of MEs without patient harm.
Area of Science:
- Pharmacy Practice
- Patient Safety
- Health Informatics
Background:
- Medication errors (MEs) are frequent during care transitions, particularly in psychiatric hospitalizations.
- Pharmacists play a crucial role in medication reconciliation (MR) to prevent MEs.
- Accurate MR is vital for ensuring patient safety and effective treatment.
Purpose of the Study:
- To evaluate the quantity and types of MEs during admission to an inpatient psychiatric unit.
- To assess the effectiveness of pharmacy-performed MR processes in identifying and correcting MEs.
Main Methods:
- A prospective quality improvement project was conducted over 28 days.
- Involved 52 patients admitted to a 22-bed inpatient psychiatry unit.
- Utilized patient interviews and electronic pharmaceutical claims data (EPCD) for MR.
Main Results:
- 29 MEs were identified in 16 patients out of 52 reviewed.
- Common MEs included medication omissions (34%) and incorrect frequencies (28%).
- Errors related to electronic pharmaceutical claims data (EPCD) double-checking were most frequent.
Conclusions:
- Pharmacy-performed MR effectively identifies MEs during psychiatric admissions.
- Most identified MEs were correctable by psychiatric pharmacists, with 97% resolved without harm.
- Improvements in MR processes, especially concerning EPCD review, are needed to further reduce medication errors.
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