Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)

NCT ID: NCT01065675

Last Updated: 2012-12-28

Basic Information

• Recruitment Status: TERMINATED
• Clinical Phase: NA
• Total Enrollment: 153 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2010-02-28
• Study Completion Date: 2011-05-31

Brief Summary

Up to 50% of medication errors and 20% of adverse drug reactions (ADRs) in the hospital setting are estimated to be related to communication issues regarding patient medications at various transition points of care from admission to discharge. The Joint Commission (TJC) requires accurate and complete medication reconciliation occur at each transition point throughout hospitalization. Evidence from NQF demonstrates pharmacists (RPh) are the most effective medication management team leaders in the implementation of medication management practices and design of medication error reduction strategies; medication reconciliation is one of the five safety objectives pharmacists are recommended to lead. In addition, the Massachusetts Coalition for the Prevention of Medical Errors states strong evidence supports the use of pharmacy technicians (CPhT) in conjunction with pharmacists in completing accurate medication histories.

WMC nurses (RN) currently are involved in the medication reconciliation process. In 2009, a Medication Use Evaluation (MUE) of Medication Reconciliation Accuracy found a 67% medication error rate on admission determined by comparing the nurse-obtained medication history to the pharmacist-obtained medication history. The number of home medications identified by the pharmacist compared to the nurse was 411 versus 312 (p<0.0001). The total percentage of medication errors prevented by the pharmacist was 66.2. Using the VA Healthcare Failure Mode Effects Analysis - HFMEA™ Hazard Scoring Matrix, 3 independent pharmacist reviewers found that 18% of patients interviewed had a score greater than 7, and 3 patients had a score of 12 (major/probable), if the discrepancies would not have been identified and corrected by the pharmacist conducting the admission medication reconciliation audit. The same patients' discharge medication reconciliation and discharge medication lists were retrospectively reviewed for the MUE, and the total percentage of patients with medication errors on discharge was 43%.

Conditions

Medication Reconciliation; Emergency Department

Keywords

Medication Reconciliation; Emergency Department; Nurse; Pharmacist; Certified Pharmacy Technician; Medication reconciliation: inpatients admitted from the ED

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: HEALTH_SERVICES_RESEARCH
• Blinding Strategy: SINGLE

Interventions

Medication reconciliation completed by a RN, CPhT, or RPh

To determine which patients benefit the most from medication histories obtained by the RN, CPhT, or RPh. Patients will be admitted as inpatients through the ED with medication histories finalized electronically by the RN at the admitting unit.

Intervention Type: OTHER

Other Intervention Names

Medication Reconciliation; Pharmacist; Nurse; Certified Pharmacy Technician; Emergency Department; ED

Eligibility Criteria

Inclusion Criteria

• Patients admitted as inpatients from the Emergency Department

Exclusion Criteria

• Prisoners (because the IRB does not have a prisoner representative)
• Patients not admitted as inpatients through the Emergency Department
• Patients admitted more than once during the study period

• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Cardinal Health

INDUSTRY

Sponsor Role: collaborator

Wesley Medical Center

OTHER

Sponsor Role: lead

Responsible Party

Joan Kramer

Clinical Research Pharmacist

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Joan S Kramer, PharmD

Role: PRINCIPAL_INVESTIGATOR

Wesley Medical Center

Locations

Wesley Medical Center

Wichita, Kansas, United States

Countries

United States

Other Identifiers

09-068

Identifier Type: -

Identifier Source: org_study_id