Elsevier

Geriatric Nursing

Volume 31, Issue 3, May–June 2010, Pages 188-196
Geriatric Nursing

Feature Article
Nurse Identified Hospital to Home Medication Discrepancies: Implications for Improving Transitional Care

https://doi.org/10.1016/j.gerinurse.2010.03.006Get rights and content

Care transitions are clinically dangerous times, particularly for older adults with complex health problems. This article describes the most common medication discrepancies identified by nurses during patients' (n = 101) hospital to home transition. Findings indicated that medication discrepancies were astoundingly widespread, with 94% of the participants having at least 1 discrepancy. The average number of medication discrepancies identified was 3.3 per participant. Medication discrepancies were identified in virtually all classes of medications, including those with high safety risks. Evidence-based best practices to reduce transition-related medication discrepancies are presented.

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.

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  • 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.

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