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We did not register this study with a database such as PROSPERO. A community liaison pharmacist
requested the patient's GP refer the patient for a home medication review (HMR) and provided the
GP with information about specific medication risk factors or recommendations from the hospital
team. In addition, this review did not aim to provide a definitive summary statistic for the frequency
of medication safety events but rather to show the range in measures and estimates. Rockville, MD:
AHRQ; 2008. 49. ? Miller GC, Britth HC, Valenti L. OpenUrl PubMed 88. ? Gandhi TK, Seger AC,
Overhage JM, et al. OpenUrl CrossRef PubMed 53. ? Ryan C, O'Mahony D, Kennedy J, Weedle P,
Byrne S. OpenUrl CrossRef PubMed 67. ? Peek N, Gude WT, Keers RN, et al. OpenUrl PubMed
33. ? Corona RJ, Altagracia MM, Kravzov JJ, Vazquez CL, Perez ME, Rubio-Poo C. Gurses,
Zachary N. Hendrix, Timothy Kenny and Yan Xiao. Since we are aware of it, writing specialists
complete every review from scratch. Evaluation of a pharmacist-led actionable audit and feedback
intervention for improving medication safety in UK primary care: an interrupted time series analysis.
Economic analysis of the prevalence and clinical and economic burden of medication error in
England. Download Free PDF View PDF See Full PDF Download PDF Loading Preview Sorry,
preview is currently unavailable. The system allowed a 'point and click' method of prescribing for
physicians' ordering inpatient and discharge medications, integration with the hospital's pharmacy
ordering system and use of clinical decision support tool. What happens to the medication regimens
of older adults during and after an acute hospitalization. However, there is a lack of published data
on the uptake of individual patient supply systems for medications in Australian hospitals despite
evidence supporting its use in reducing medication errors. Error rates were assessed two months after
the intervention and compared with a control hospital. Error types were classified using an in-house
classification system and the risk rating was assessed by a blinded, independent physician using
standard risk assessment criteria. Computerised provider order entry combined with clinical decision
support systems to improve medication safety: a narrative review. These studies have highlighted
barriers and facilitators to the introduction of such systems that can inform wider implementation.
Project Chronicle. 2005, Canberra: Commonwealth of Australia. This study involved semi-structured
interviews and a focus group examining the discharge process, liaison between hospital and
community settings and the possible role of a community liaison pharmacist. OpenUrl CrossRef
PubMed 79. ? Henriksen K, Battles JB, Marks ES, Lewin DI O'Connor PJ, Sperl-Hillen JAM,
Johnson PE, Rush WA. While these studies do not provide sound evidence of effectiveness, they
warrant further research in these areas. Polypharmacy and specific comorbidities in university
primary care settings. Gurses, Zachary N. Hendrix, Timothy Kenny, Yan Xiao. Impact of potentially
inappropriate prescribing on adverse drug events, health related quality of life and emergency
hospital attendance in older people attending general practice: a prospective cohort study. A
computer-generated discharge summary system enabled a discharge prescription to be generated
based on information entered by the medical officer. At 24 hours post-admission a senior clinical
pharmacist reviewed the medication history and medication chart and recorded and resolved any
prescribing errors. The Commission initiated the decision to submit the manuscript for publication.
Prescription error rates for patients during a 5 day control period were compared with error rates in
the following week when a pharmacist ED service was provided. NOTE: We only request your email
address so that the person you are recommending the page to knows that you wanted them to see it,
and that it is not junk mail. A database of prevented prescribing incidents (near-miss incidents)
detected by hospital pharmacists was developed. In the intervention period a dedicated ED
pharmacist interviewed patients using a structured medication reconciliation form to obtain a
medication history and reconciled the history with the ED medication chart where possible or passed
the information to the ward pharmacist. OpenUrl CrossRef PubMed 65. ? Lenander C, Elfsson B,
Danielsson B, Midlov P, Hasselstrom J. The specialists of our service synthesize and critically
evaluate them to deliver a detailed and objective copy. Advances in Patient Safety: New Directions
and Alternative Approaches (Vol. 4, Technology and Medication Safety). OpenUrl CrossRef
PubMed 3. ? Elder NC, Pallerla H, Regan S. A policy for prescribing potassium chloride in
millimoles rather than grams was also implemented. Download citation Received: 17 April 2009
Accepted: 22 September 2009 Published: 22 September 2009 DOI: Share this article Anyone you
share the following link with will be able to read this content: Get shareable link Sorry, a shareable
link is not currently available for this article. Joint Commission Journal on Quality and Patient Safety.
2000, 26: 563-575. CAS. PhD Find this author on Google Scholar Find this author on PubMed
Search for this author on this site. The titles of the first search were reviewed by 1 investigator (RY)
to eliminate studies that clearly did not meet our criteria. References 1. ? Sarkar U, Lopez A, Maselli
JH, Gonzales R. The risk of bias table for each interventional study is presented in Supplementary
Table 4. Potentially inappropriate prescribing among people with dementia in primary care: a
retrospective cross-sectional study using the Enhanced Prescribing Database. The same medical staff
were responsible for both prescription types. Also, ask your doctor, pharmacist or nurse to review all
your medications to see if any can be stopped or reduced. Proper use: how do I take my medications,
and for how long. Using electronic health records to identify adverse drug events in ambulatory care:
a systematic review. Reliance on incident reports may have meant errors were undetected as
incidents are known to be under-reported. This study suggests a transition coordinator can improve
aspects of medication management during the transition from hospital to residential aged care,
however, no impact on adverse drug events was demonstrated. OpenUrl CrossRef PubMed 12. ?
Munn Z, Moola S, Lisy K, Riitano D, Tufanaru C. Data Extraction and Synthesis Preliminary data
were abstracted onto an Excel spreadsheet. There’re so many frauds out there, so security concerns
are healthy concerns. Intensive training was provided to medical officers and nursing staff. High
prevalence of medication discrepancies between home health referrals and Centers for Medicare and
Medicaid Services home health certification and plan of care and their potential to affect safety of
vulnerable elderly adults. Barriers to the service included GP time constraints and unwillingness to
learn how to make an HMR referral. EER made a substantial contribution to drafting and editing of
this paper and provided direction and guidance in the review of the relevant literature. Physicians'
decisions to override computerized drug alerts in primary care.
MD Find this author on Google Scholar Find this author on PubMed Search for this author on this
site Kimberly G. This paper provides a brief overview on how the functioning of healthcare systems
affects the safety environment and describes how stakeholder involvement, research participation,
and targeted education and training can help facilitate better safety measures and practices, provid.
This can prevent a mistake with your medicines like missing a dose of a medication you need, or
getting two medications that shouldn't be taken together. A computer-generated discharge summary
system enabled a discharge prescription to be generated based on information entered by the medical
officer. Interventions could include any aimed to affect PCP prescribing. This model used a
systematic approach to identify human-computer interaction processes as well as the context in
which electronic prescribing systems are used (such as health professional cultures, organizational
factors). The ADE rate was sensitive to the method of data collection. Double checking versus
single-checking by nurses and patient self-administration in hospital has been assessed in small
studies. On the other hand, the writing professional will present original conclusions based on the
already conducted research. After each scenario the nurses were asked whether they detected the
errors, whether they would have modified their practice and whether they were aware of the error
concept. In comparison with stage one, there were substantial and maintained improvements in
faxing of discharge summaries from hospitals to GPs (p Shared electronic medication records
Initiatives to develop systems to improve the sharing of medication information between patients
and various healthcare providers through a shared electronic medical record have been funded
through the Australian Government. Analysts reviewed medication error event reports that indicated
the use of overrides submitted from January 2013 through December 2014 to the Pennsylvania
Patient Safety Reporting System. Grey literature searching involved Internet searching, reviewing
relevant Web sites, and searching electronic databases of grey lite. Potential roles for the service
included providing advice and reassurance about medications, assessment of a patient's medication
understanding and ability to manage their medicines at home, education and reinforcement of
instructions about medicines and communication of patient progress with service providers. A
retrospective survey of GPs, community pharmacists and accredited pharmacists found most agreed
that the service improved the link between the hospital and community setting. Available from:. 96. ?
Crane S, Sloane PD, Elder N, et al. Evaluation of drug-related problems in older polypharmacy
primary care patients. Appropriate prescribing in the elderly: an investigation of two screening tools,
Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the
elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland. The
aim of this review is to report MAEs occurring in pediatric inpatients. Whether you need to write a
literature review in a day or a month, you’ll receive it without the slightest delay. Methodological
guidance for systematic reviews of observational epidemiological studies reporting prevalence and
cumulative incidence data. OpenUrl PubMed 48. ? Henriksen K, Battles JB, Keyes MA, Grady ML
Lynch J, Rosen J, Selinger HA, Hickner J. Our study was limited to only the medication list and
prescribing in the primary care center. The study included 110 older adults discharged from three
metropolitan hospitals to long-term care. Gurses, Zachary N. Hendrix, Timothy Kenny and Yan Xiao.
The system, called the Adelaide Regional Connector (ARC), was under prototype development in
2002. The study was conducted over a two-year period with 591 nurses participating. That’s why for
Patient Safety Week 2017, the hospital is actively encouraging patients to ask the following five
questions about their medication when they see their doctor, nurse or pharmacist: Changes: have any
medications been added, stopped or changed, and why. Rockville, MD: AHRQ; 2008. 49. ? Miller
GC, Britth HC, Valenti L. This study analysed medication incidents reported through the hospital's
reporting scheme and did not include any independent assessment of errors.
The rate of ADE also varied widely (0.047% to 14.7% overall; 7.4% to 9.4% for high-risk patients;
0.047% to 14.7% for a general patient population). Subsequently, a forum was held to review results
and reassess action plans. One new model included a transition co-ordinator to assist transfer of
medication information for patients discharged from hospital to residential aged-care facilities. There
may have been discrepancies between the electronic reports and the medications that PCPs and
patients considered to be the active list. Incidence of adverse drug events and potential adverse drug
events: implications for prevention. Physicians' decisions to override computerized drug alerts in
primary care. It concluded that a number of available systems were suitable for use in Australian
hospitals, but that change management issues needed to be addressed for implementation to occur
more widely. The study included 110 older adults discharged from three metropolitan hospitals to
long-term care. A national coding system is required to allow the electronic transmission, storage and
use of medication information. It is possible that relevant studies were missed using this strategy.
Barriers to home medication reviews after hospital discharge include workload factors for both
general practitioners and pharmacists and lack of patient interest, as well as the ability to engage an
accredited pharmacist in a timely manner. The intervention enabled detection of adverse drug events
that would have been missed in the existing system. To browse Academia.edu and the wider internet
faster and more securely, please take a few seconds to upgrade your browser. The logistics of
providing the service included the need for domiciliary visits to be conducted within one week of
discharge, but preferably within 24-48 hours. Medication safety in primary care practice: results from
a PPRNet quality improvement intervention. However, Australian studies assessing outcomes of this
strategy on medication incidents or patient outcomes are still lacking. In stage two, progress was
assessed using specific indicators. A computer-generated discharge summary system enabled a
discharge prescription to be generated based on information entered by the medical officer. The five
questions help patients take more control over their medication safety and become an active part of
their own care. OpenUrl CrossRef PubMed 68. ? Singh R, Anderson D, McLean-Plunkett E, et al.
However, I am thoroughly satisfied with the work of expert. Reducing inappropriate polypharmacy:
the process of deprescribing. Advances in Patient Safety: From Research to Implementation (Vol. 1,
Research Findings). The association of EHR drug safety alerts and co-prescribing of opioids and
benzodiazepines. Grey literature searching involved Internet searching, reviewing relevant Web sites,
and searching electronic databases of grey lite. Method Eligibility Criteria Studies were included if
they were restricted to primary care populations only, measured either potential for harm or actual
harm from medications, reflected medications managed by the primary care clinic PCPs, and used
EHRs with e-prescribing. Patients have to be an active partner in their health to ensure that they
have the information they need to use their medications safely. If you’d also rather trust an expert
than write an overview yourself, there’s good news. The Sauer's Triangle of Dependencies model was
used to examine the organisational context in which an information system is placed. Medication
errors in primary care in Riyadh City, Saudi Arabia.
Since this review, further Australian studies addressing the evidence base and experiences in their
implementation have now been published. Participants included medical practitioners, community
nurses, community pharmacists, hospital pharmacists, consumers and hospital administrators from a
division of general practice in Victoria. This review found there were some sound evidence-based
programs used in hospitals in some States. College-level literature review help is at your disposal.
Drug-related problems identified by pharmacists conducting medication use reviews at a primary
health center in Qatar. If your review type is absent from the service list on the order page, choose
the “Other” option. One of the 11 studies was judged to be of low risk of bias, 4 with some concern,
6 with a high risk of bias. Methods: Twelve bibliographic databases were searched for studies
published between January 2000 and February 2015 using “medication administration errors”,
“hospital”, and “children” related terminologies. Medical Journal of Australia. 2001, 174 (6): 277-
280. CAS. Posthospital medication discrepancies: prevalence and contributing factors. In general,
domiciliary visits were considered the most appropriate mechanism, however telephone calls were
also suggested. Most identified studies only measured PIPs and not patient harms. Medication lists
were obtained from available clinic or national pharmacy records. Medication Administration errors
See Full PDF Download PDF About Press Blog People Papers Topics Job Board We're Hiring.
Reducing inappropriate outpatient medication prescribing in older adults across electronic health
record systems. All medication and fluid charts in the ED department were assessed for error-prone
abbreviations at a randomly selected time each day for one week before the intervention and one
week following. See Full PDF Download PDF About Press Blog People Papers Topics Job Board
We're Hiring. Medication errors in primary care in Riyadh City, Saudi Arabia. These were developed
by physician consensus and in collaboration with the product manufacturer. Factors associated with
the use of potentially inappropriate medications by older adults in primary health care: an analysis
comparing AGS Beers, EU(7)-PIM List, and Brazilian Consensus PIM criteria. The baseline levels of
errors at the intervention hospital (approximately 40%) were higher than those of the control hospital
(25%), making comparison difficult. It concluded that a number of available systems were suitable
for use in Australian hospitals, but that change management issues needed to be addressed for
implementation to occur more widely. She offered her perspective about what patients can do to
make their medication experience safer. --- Why are the five questions so important for medication
safety. A survey was sent to 21 senior clinicians who received reports through the program, of which
10 (47%) responded. Part 2 of the review examined the Australian evidence base for approaches to
build safer medication systems in acute care. The ranges of reported ADE and medication error rates
illustrate the inadequacies of current evidence to suggest both the scope of medication error-related
harms as well as how medication errors should be defined. The liaison pharmacist accompanied the
accredited pharmacist on the HMR visit to provide written resources and other information to the
patient. Improvement Toolkit. Wave 1. 2005, Canberra: Commonwealth of Australia. OpenUrl
CrossRef PubMed 85. ? Smith LB, Golberstein E, Anderson K, et al. The system, called the Adelaide
Regional Connector (ARC), was under prototype development in 2002. Other models for
development of medication liaison services between hospital and community settings have been
examined in major hospitals in NSW and South Australia.
Improving medication safety in primary care: a review and consensus procedure by the LINNEAUS
collaboration on patient safety in primary care. For studies with interventions to improve medication
safety, we evaluated ambulatory patients cared for by primary care physicians (PCPs) who prescribed
medications from their clinics. Potentially inappropriate medication use among geriatric patients in
primary care setting: a cross-sectional study using the Beers, STOPP, FORTA and MAI criteria.
Rockville, MD: AHRQ; 2005. 80. ? Henriksen K, Battles JB, Keyes MA, Grady ML Raebel MA,
Chester EA, Brand DW, Magid DJ. Since we are aware of it, writing specialists complete every
review from scratch. Evidence for systems-based approaches to understanding and preventing
medication errors Systems to allow health services to assess medication systems and performance
The National Medication Safety Breakthrough Collaborative was a key initiative of the former
Australian Council for Safety and Quality, which aimed to reduce harm from medications.
Implementation research has since been conducted in Australia, however, outcome studies are still
lacking. Studies on strategies to improve communication between different care settings, such as
liaison pharmacist services, have focussed on implementation issues now that funding is available for
community-based services. First, here a wide variety of disciplines are on offer. Download Free PDF
View PDF See Full PDF Download PDF Loading Preview Sorry, preview is currently unavailable.
EER made a substantial contribution to drafting and editing of this paper and provided direction and
guidance in the review of the relevant literature. Factors associated with the use of potentially
inappropriate medications by older adults in primary health care: an analysis comparing AGS Beers,
EU(7)-PIM List, and Brazilian Consensus PIM criteria. Potential drug-drug and drug-disease
interactions in prescriptions for ambulatory patients over 50 years of age in family medicine clinics in
Mexico City. Their next merit is the writing techniques they practice. Among the interventional
studies, most also measured process outcomes, such as whether the PCP altered a prescription based
on a pharmacist's feedback or a drug allergy was not listed in the medical record, not patient-oriented
outcomes. Chart design assessment was performed on 15 design features and compared with the
previously used RPH chart, four other WA hospital charts and nine charts from teaching hospitals in
other states and territories. In studies using national pharmacy databases, it is possible that some of
the prescriptions were written by non-PCPs. These included medications requiring calculations,
drugs of addiction, cytotoxics, new drugs, epidurally administered drugs, variable dose insulin, blood
products and high dose potassium chloride. The PCI DSS standard protects quick and smooth
transactions. This quasi-pre-test post-test design study aimed to improve communication between
general practitioners and hospital staff in an Area Health Service in NSW. The complete search
strategy with keywords and other detailed methods is available in the supplementary online material.
The majority of the studies (30) used their own definition of error. Pharmacologically inappropriate
prescriptions for elderly patients in general practice: How common. What happens to the medication
regimens of older adults during and after an acute hospitalization. Adverse drug events in general
practice patients in Australia. Outcomes could include any measure of medication safety or patient
harm. You can download the paper by clicking the button above. It’s achievable with writers who
have gained a PhD themselves. Analysts reviewed medication error event reports that indicated the
use of overrides submitted from January 2013 through December 2014 to the Pennsylvania Patient
Safety Reporting System. A series of workshops were conducted which identified changes that could
be made to overcome these communication barriers.
The majority of the studies (30) used their own definition of error. OpenUrl CrossRef PubMed 20. ?
Aspinall MB, Whittle J, Aspinall SL, Maher RL Jr.., Good CB. Improving adverse-drug-reaction
reporting in ambulatory care clinics at a Veterans Affairs hospital. Impact of potentially inappropriate
prescribing on adverse drug events, health related quality of life and emergency hospital attendance
in older people attending general practice: a prospective cohort study. This review has identified five
types of interventions to reduce hospital MAEs in children: barcode medicine administration,
electronic prescribing, education, use of smart pumps, and standard concentration. Adverse drug
events in U.S. adult ambulatory medical care. Starting is the hardest thing, especially if it’s a
literature review. Further research on the impact of education on incident rates and medication error
detection in the acute care setting is still needed. In the first round, 266 subgroups were classified as
appropriate to the assigned scenario, 32 were classified as uncertain, and none were classified as
inappropriate. Reducing inappropriate polypharmacy: the process of deprescribing. One of the 11
studies was judged to be of low risk of bias, 4 with some concern, 6 with a high risk of bias. Patient
safety in primary care: conceptual meanings to the health care team and patients. The program used
simulated medication administration scenarios of frequently occurring medication errors with
potential for harm. They are guaranteed to have in-depth knowledge and practical and research
expertise in the field. This can prevent a mistake with your medicines like missing a dose of a
medication you need, or getting two medications that shouldn't be taken together. Method Eligibility
Criteria Studies were included if they were restricted to primary care populations only, measured
either potential for harm or actual harm from medications, reflected medications managed by the
primary care clinic PCPs, and used EHRs with e-prescribing. Patients are at high risk of fragmented
care, adverse drug events, and medication errors during transitions of care. Joint Commission Journal
on Quality and Patient Safety. 2000, 26: 563-575. CAS. The identification of medical errors by
family physicians during outpatient visits. OpenUrl PubMed 51. ? Perez T, Moriarty F, Wallace E,
McDowell R, Redmond P, Fahey T. Monitor: how will I know if my medication is working and what
side effects do I watch for. This has the potential to facilitate the use of bar coding technology.
Improving medication safety in primary care: a review and consensus procedure by the LINNEAUS
collaboration on patient safety in primary care. Project Chronicle. 2005, Canberra: Commonwealth of
Australia. The review also illustrated the complexity and multifaceted nature of MAEs. OpenUrl
CrossRef PubMed 3. ? Elder NC, Pallerla H, Regan S. We limited our searches to our definition of
studies in the EHR era. Forty-three studies were noninterventional and 13 included an intervention.
Conflict of interest: RAY discloses that he is the sole owner of SENTIRE, LLC, which is a novel
documentation, coding, and billing system for primary care. Prescription error rates for patients
during a 5 day control period were compared with error rates in the following week when a
pharmacist ED service was provided. The baseline levels of errors at the intervention hospital
(approximately 40%) were higher than those of the control hospital (25%), making comparison
difficult.