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药学专业学生主导的出院用药配送服务的影响

Impact of a pharmacy student-driven medication delivery service at hospital discharge.

作者信息

Rogers Jacalyn, Pai Vinita, Merandi Jenna, Catt Char, Cole Justin, Yarosz Shannon, Wehr Allison, Durkin Kayla, Kaczor Chet

机构信息

Rainbow Babies and Children's Hospital, Cleveland, OH

Nationwide Children's Hospital, Columbus, OH.

出版信息

Am J Health Syst Pharm. 2017 Mar 1;74(5 Supplement 1):S24-S29. doi: 10.2146/ajhp150613.

Abstract

PURPOSE

A pharmacy student-driven discharge service developed for patients to reduce the number of medication errors on after-visit summaries (AVSs) is discussed.

METHODS

An audit of AVS documents was conducted before the implementation period (September 3 to October 23, 2013) to identify medication errors. As part of the audit, a pharmacist review of the discharge medication list was completed to determine the number and types of errors that occurred. A student-driven discharge service with AVS review was developed in collaboration with nursing and medical residents. Students reviewed a patient's AVS, delivered the discharge prescriptions to bedside, and conducted medication reconciliation with the patient and family. The AVS audit was conducted after implementation of these services to assess the impact on medication errors.

RESULTS

It was observed that 72% (108 of 150) of AVSs contained at least 1 error before discharge and AVS review. During the 2-month postimplementation period (September 3 to October 23, 2014), this decreased to 27% (34 of 127), resulting in a 52% absolute reduction in the number of AVSs with at least 1 medication error ( < 0.0001). The most common error was as-needed medication with no indication, which decreased from 55% in the preimplementation audit to 16% in the postimplementation audit. Prescribing to Nationwide Children's Hospital's outpatient pharmacy increased from 57% in the preimplementation period to 73% in the postimplementation period for the general pediatrics service.

CONCLUSION

A pharmacy student-driven discharge and medication delivery service reduced the number of AVSs and increased access to medications for patients.

摘要

目的

讨论一项由药学专业学生推动的出院服务,该服务旨在减少患者出院小结(AVS)上的用药错误数量。

方法

在实施期(2013年9月3日至10月23日)之前对AVS文件进行审核,以识别用药错误。作为审核的一部分,完成了药剂师对出院用药清单的审查,以确定发生的错误数量和类型。与护理人员和住院医师合作开发了一项由学生推动的出院服务,并对AVS进行审查。学生们审查患者的AVS,将出院处方送到床边,并与患者及其家属进行用药核对。在实施这些服务后进行AVS审核,以评估对用药错误的影响。

结果

观察到在出院和AVS审查之前,72%(150份中的108份)的AVS至少包含1个错误。在实施后的2个月期间(2014年9月3日至10月23日),这一比例降至27%(127份中的34份),导致至少有1个用药错误的AVS数量绝对减少了52%(P<0.0001)。最常见的错误是无用药指征的按需用药,从实施前审核中的55%降至实施后审核中的16%。普通儿科服务的处方发送到全国儿童医院门诊药房的比例从实施前的57%增加到实施后的73%。

结论

一项由药学专业学生推动的出院和送药服务减少了AVS的数量,并增加了患者获得药物的机会。

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