Feature ArticleNurse Identified Hospital to Home Medication Discrepancies: Implications for Improving Transitional Care
Section snippets
Inclusion and Exclusion Criteria
This analysis was based on data from a larger study testing the effectiveness of an intervention designed to enhance home care nurses' abilities to detect and resolve hospital-to-home transition-related medication discrepancies. The parent study was approved for human subjects participation by the institutional review boards of the involved hospitals and the authors' affiliated university. Written informed consent was provided by all participants. The data used for the descriptive analyses
Sample
The sample includes the first 101 participants randomized to the intervention arm of the clinical trial. As is typical of patients who receive home care services, the majority of participants (63%) were female, participants' average age was 73 years, and their hospital discharge medication lists identified a mean of 10.4 medications (Table 2).
Data Analyses and Results
Descriptive statistics were computed using SPSS 17.0. Of the 101 participants, 95 (94%) had at least 1 identified medication discrepancy. Medication
Frequency and Types of Discrepancies
This study sought to describe the most common medication discrepancies identified by nurses during patient transitions from hospital to home. Home care nurse medication assessments revealed that medication discrepancies occurred after hospital discharge for the majority of participants. Medication discrepancies reported in this study are even higher than those reported in other research where findings range from 15% to 76%.2, 6, 11, 12, 13 The substantially higher rate of medication
Summary
Medication discrepancies during the hospital-to-home transition are common. Medication discrepancies are wrought with potential patient safety risks, may lead to poor outcomes including adverse events, and are a source of preventable health care utilization. In our study, 94% of the participants transitioning from acute care to home care had at least 1 nurse-identified medication discrepancy. Medication discrepancies were identified for virtually all classes of medications, including those that
Acknowledgment
Support for this work was provided by a grant from the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative.
CYNTHIA F. CORBETT, PhD, is an Associate Professor at Washington State University, College of Nursing, Spokane, WA.
References (29)
- et al.
Identifying post-acute medication discrepancies in community dwelling older adults: a new tool
Am J Geriatr Pharmacother
(2004) - et al.
Medication reconciliation for reducing drug-discrepancy adverse events
Am J Geriatr Pharmacother
(2006) - et al.
Improving medication reconciliation in the outpatient setting
Jt Comm J Qual Patient Saf
(2007) - et al.
Rehopsitalizations among patients in the Medicare Fee-for-Service program
N Engl J Med
(2009) - et al.
Posthospital medication discrepancies: prevalence and contributing factors
Arch Intern Med
(2005) - et al.
Exploring the concept of medication discrepancy within the context of patient safety to improve population health
Adv Nurs Sci
(2009) - et al.
The Care Transitions Intervention: results of a randomized controlled trial
Arch Int Med
(2006) - et al.
Accuracy of information on medicine in hospital discharge summaries
Int Med J
(2006) - et al.
Effectiveness of a pharmacist-nurse intervention on resolving medication discrepancies for patients transitioning from hospital to home health care
Am J Health-Syst Pharm
(2009) - et al.
The incidence and severity of adverse events affecting patients after discharge from the hospital
Ann Intern Med
(2003)
Implementation of the Care Transitions Intervention: sustainability and lessons learned
Prof Case Mgmt
American Hospital Form Service (AHFS) Drug Information 2010
Medication reconciliation: Harvard Pilgrim Health Care's approach to improving outpatient medication safety
J Healthc Qual
Effects of medication reconciliation with and without patient counseling on the number of pharmaceutical interventions among patients discharged from the hospital
Ann Pharmacother
Cited by (0)
CYNTHIA F. CORBETT, PhD, is an Associate Professor at Washington State University, College of Nursing, Spokane, WA.
STEPHEN M. SETTER, PharmD, DVM, is an Associate Professor at Washington State University, College of Pharmacy, Spokane, WA.
KENN B. DARATHA, PhD, is an Assistant Professor at Washington State University, College of Nursing, Spokane, WA.
JOSHUA J. NEUMILLER, PharmD, is an Assistant Professor at Washington State University, College of Pharmacy, Spokane, WA.
LINDY D. WOOD, PharmD, is a clinical research fellow at Washington State University, College of Pharmacy, Spokane, WA.