The work described here was presented at the Pharmacy Together 2019 conference.
Medication discrepancies on medication charts at admission to hospital remain commonplace. A recent study carried out in the United States identified that pharmacy technicians completing admission drug histories instead of ‘clerking’ doctors resulted in a significant decrease in medication discrepancies. This study sought to determine whether adopting a modified version of this intervention (where pharmacy technicians also transcribed paper admission charts) would have a similar effect on medication discrepancies at a district general hospital.
The study, carried out in October 2108, was comprised of a two day intervention period followed by a two week control period. Prior to the study, the two intervention pharmacy technicians completed a chart transcribing e-learning package and competency assessment. In the intervention, all patients referred by a GP for acute medical assessment had a drug history taken and chart transcribed by a pharmacy technician.
Chart transcriptions were checked by a pharmacist and signed by a doctor prior to them being made available for use. In the control period, admission drug histories and chart transcriptions were carried out by junior doctors as per normal practice. Discrepancy data were collected by pharmacists in both periods on a modified version of the data collection form designed by Urban. Chart endorsing errors were also recorded in the intervention period on a data collection form designed for the purpose.
No discrepancies were identified on intervention charts, compared to 44 discrepancies in the control group
Data were available for 25 charts transcribed in the intervention period (251 items; median drug history items per patient: 10) and for 16 charts from the control period (159 items; median drug history items per patient: 9).
No discrepancies were identified on intervention charts, compared to 44 discrepancies in the control group. The Number Needed to Transcribe (NNT) for pharmacy technicians was 3.61 to prevent one discrepancy. Six minor endorsing errors were identified on intervention charts.
Pharmacy technicians carrying out admission drug histories and chart transcription instead of junior doctors could cause a marked reduction in medication discrepancies. The findings of the study should be interpreted with caution due to the brief nature of the intervention and the small number of charts included in the analysis. However, the ability of pharmacy technicians to carry out these tasks at admission has been demonstrated. A larger pilot is justified, which should be carried out over a period of months and should look to incorporate patients arriving at the hospital via the Emergency Department.
Hannah Lee, Hannah Thompson, Amanda Holloway, Sasha Nickson & Dr Vikas Lodhi, Prince Charles Hospital, Cwm Taf Morgannwg University Health Board.
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Competing interest statement:
The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.