Chhabra Anmol, Quinn Andrea, Ries Amanda
1 Palos Hospital, Palos Heights, IL, USA.
J Pharm Pract. 2019 Aug;32(4):394-398. doi: 10.1177/0897190017753783. Epub 2018 Jan 22.
Accurate history collection is integral to medication reconciliation. Studies support pharmacy involvement in the process, but assessment of global time spent is limited. The authors hypothesized the location of a medication-focused interview would impact time spent.
The objective was to compare time spent by pharmacists and nurses based on the location of a medication-focused interview. Time spent by the interviewing pharmacist, admitting nurse, and centralized pharmacist verifying admission orders was collected. Patient groups were based on whether the interview was conducted in the emergency department (ED) or medical floor. The primary end point was a composite of the 3 time points. Secondary end points were individual time components and number and types of transcription discrepancies identified during medical floor interviews.
Pharmacists and nurses spent an average of ten fewer minutes per ED patient versus a medical floor patient ( = .028). Secondary end points were not statistically significant. Transcription discrepancies were identified at a rate of 1 in 4 medications. Post hoc analysis revealed the time spent by pharmacists and nurses was 2.4 minutes shorter per medication when interviewed in the ED ( < .001).
The primary outcome was statistically and clinically significant. Limitations included inability to blind and lack of cost-saving analysis.
Pharmacist involvement in ED medication reconciliation leads to time savings during the admission process.
准确收集病史对于用药核对至关重要。研究支持药剂师参与该过程，但对总体花费时间的评估有限。作者推测以用药为重点的访谈地点会影响所花费的时间。
目的是根据以用药为重点的访谈地点比较药剂师和护士所花费的时间。收集访谈药剂师、接诊护士以及核对入院医嘱的集中办公药剂师所花费的时间。患者分组依据访谈是在急诊科（ED）还是在医疗楼层进行。主要终点是这三个时间点的综合情况。次要终点是各个时间组成部分以及在医疗楼层访谈期间发现的转录差异的数量和类型。
与医疗楼层的患者相比，药剂师和护士为每位急诊患者平均少花费10分钟（P = 0.028）。次要终点无统计学意义。转录差异的发现率为每4种药物中有1种。事后分析显示，在急诊科进行访谈时，药剂师和护士为每种药物花费的时间缩短了2.4分钟（P < 0.001）。
主要结果在统计学和临床上均具有显著意义。局限性包括无法设盲以及缺乏成本节约分析。
药剂师参与急诊用药核对可在入院过程中节省时间。
