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Mind the gap – using clinical audit to minimise medication information errors at hospital discharge

  • Ashok Kumar Jainer (a1), Fabida Noushad (a2), Tim Coupe (a1), Chaya Rekha Mupiri (a3) and Anoop Saraf (a4)...
Abstract
Aims and method

We conducted a retrospective audit of 100 discharge summaries to evaluate the accuracy of medication recording and the recording of as required (PRN) prescribing, and to see whether or not general practitioners were advised on how long to continue the latter. After a formal guideline was introduced we conducted a re-audit.

Results

There was an improvement in summaries recording medication correctly (from 64 to 83%). The number of summaries with one or more missing medications halved and PRN sedative prescribing reduced from 18 to 3%, but provision of advice on the latter did not improve.

Clinical implications

Accurate recording of medication in the discharge summary is an important element of the transfer of patient care to the general practitioner. Medication errors may pose serious health risks and undermine patient confidence in the service. The clinical audit and interventions implemented helped to reduce errors in medication recording in discharge summaries.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Fabida Noushad (fabida@gmail.com)
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Declaration of interest

None.

Footnotes
References
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1 Boockvar, KS, Liu, S, Goldstein, N, Nebeker, J, Siu, A, Fried, T. Prescribing discrepancies likely to cause adverse drug events after patient transfer. Qual Saf Health Care 2009; 18: 32–6.
2 Morcos, S, Francis, SA, Duggan, C. Where are the weakest links? A descriptive study of discrepancies in prescribing between primary and secondary sectors of mental health service provision. Psychiatr Bull 2002; 26: 371–4.
3 National Institute for Health and Clinical Excellence. Technical Patient Safety Solutions for Medicines Reconciliation on Admission of Adults to Hospital. NICE, 2007 (http://guidance.nice.org.uk/PSG001).
4 National Institute for Health and Clinical Excellence. Medicines Adherence: Involving Patients in Decisions about Prescribed Medicines and Supporting Adherence. NICE, 2009 (http://guidance.nice.org.uk/CG76).
5 Miller, RA, Gardner, RM, Johnson, KB, Hripcsak, G. Clinical decision support and electronic prescribing systems: a time for responsible thought and action. J Am Med Inform Assoc 2005; 12: 403–9.
6 Masson, N, Liew, A, Taylor, J, McGuigan, F. Risk assessment of psychiatric in-patients: audit of completion of a risk assessment tool. Psychiatr Bull 2008; 32: 13–4.
7 Kirby, J, Barker, B, Fernando, D, Jose, M, Curtis, C, Goodchild, A, et al. A prospective case control study of the benefits of electronic discharge summaries. J Telemed Telecare 2006; 12: 20–1.
8 Scullard, P, Iqbal, N, White, L, Olla, E, Thomson, GA. Improved communication between hospital and general practice using online patient discharge summaries. J Telemed Telecare 2007; 13: 56–8.
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BJPsych Bulletin
  • ISSN: 1758-3209
  • EISSN: 1758-3217
  • URL: /core/journals/bjpsych-bulletin
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Mind the gap – using clinical audit to minimise medication information errors at hospital discharge

  • Ashok Kumar Jainer (a1), Fabida Noushad (a2), Tim Coupe (a1), Chaya Rekha Mupiri (a3) and Anoop Saraf (a4)...
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