The current quality improvement initiative evaluated the medication reconciliation process within select nursing homes in Washington, DC. The identification of common types of medication discrepancies through monthly retrospective chart reviews of newly admitted patients in two different nursing homes were described. The use of high-risk medications, namely antidiabetic, anticoagulant, and opioid agents, was also recorded. A standardized spreadsheet tool based on multiple medication reconciliation implementation tool kits was created to record the information. The five most common medication discrepancies were incorrect indication (21%), no monitoring parameters (17%), medication name omitted (11%), incorrect dose (10%), and incorrect frequency (8%). Antidiabetic agents in both sites were the most used high-risk medication. This initiative highlights that medication discrepancies on admission are common in nursing homes and may be clinically impactful. More attention needs to be given to work flow processes to improve medication reconciliation considering the increased risk for adverse drug events and hospitalizations. [Journal of Gerontological Nursing and Mental Health Services, 43(4), 9-14.].

译文

当前的质量改进计划评估了华盛顿特区部分疗养院内的药物协调过程。描述了通过两个不同疗养院中新入院患者的每月回顾性图表审查来识别常见的药物差异类型。还记录了高风险药物的使用,即抗糖尿病,抗凝药和阿片类药物。创建了基于多个药物对账实施工具包的标准化电子表格工具来记录信息。五种最常见的药物差异是不正确的适应症 (21%),无监测参数 (17%),省略的药物名称 (11%),不正确的剂量 (10%) 和不正确的频率 (8%)。这两个部位的抗糖尿病药物是使用最多的高危药物。该计划强调,入院时的药物差异在疗养院中很常见,并且可能对临床产生影响。考虑到不良药物事件和住院风险的增加,需要更多地关注工作流程,以改善药物协调。[老年护理与精神卫生服务杂志,43(4),9-14。]。

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