Nurse-Pharmacist Collaboration on Medication Reconciliation: A Novel Approach to Information Management
This research brief explores whether a nurse-pharmacist led medication reconciliation protocol could efficiently and inexpensively prevent potential adverse drug events (ADEs) at the admission and discharge transitions of care. The chart shows the ranking of unintended discrepancies on admission and discharge.
Background
- About 400,000 patients are affected by adverse drug events (ADEs) each year at a national cost of approximately $3.5 billion.
- There are 1.2 to 1.8 preventable ADEs per 100 inpatient admissions.
- Incomplete medication history is a source of potentially preventable ADEs.
Key Findings
- Five hundred and sixty-three patients were enrolled in the study. Forty percent of patients experienced a medication discrepancy on admission or discharge.
- The number of discrepancies were fewer at discharge but rated higher on the potential harm scale.
- If we estimate that 0.9% of all inpatient medication errors lead to harm, applying the percentage to the total of 531 discrepancies, 4.8 of them would have caused harm.Applying the cost adjusted rate, $9300 per ADE, to the 4.8 harmful discrepancies, the total estimated cost averted would be $44, 607. This compares favorability to the nurse-pharmacist intervention cost of $18,000.
- Each additional medicine increased the odds of an unintended discrepancy by 8.7%. The number of medications was significantly associated with discrepancy occurrence.
- Compliance with patients’ complete home medication lists within 24 hours of admission increased from 75% pre-study to 92% after introduction of the electronic home medication list.