How accurate is your drug history? Introducing paediatric medicines reconciliation in a district general hospital

• Published in: Archives of disease in childhood 2012-05, Vol.97 (Suppl 1), p.A114
• Main Authors: Wright, J, McCarron, M, Syeda, S, McGarva, S, Finlay, L
• Format: Article
• Language: English
• Subjects: Driving ability; Hospitals
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2012-301885.272

Aims The Scottish Patient Safety Programme is currently driving improvements in the provision of safe and effective medicines management in Scotland. The introduction of medicines reconciliation sheets has been shown to reduced the prescription error rate on the acute adult medical ward of this district general hospital. Medicines reconciliation sheets improve the accuracy of the drug history by confirming the patient's medications on admission with a least one additional source of information. The aim of this audit was to reduce the error rate in paediatric hospital prescriptions by introducing a local paediatric medicines reconciliation sheet. Methods A new paediatric medicines reconciliation sheet was created in discussion with the paediatric multidisciplinary team. The case notes of five new medical admissions each week were reviewed for ten weeks. Following this, the new paediatric medicines reconciliation sheet was introduced in liaison with the paediatric unit. The case notes of five new medical admissions each week were reviewed for a further ten weeks. For each case reviewed, the number and type of prescription errors were recorded. Results The introduction of the new paediatric medicines reconciliation sheet reduced the error rate in paediatric hospital prescriptions. The results were (table 1); Abstract G222(P) Table 1 Before Sheet After Sheet No. Case Notes Reviewed 50 50 No. with 1+ Prescription Errors 19 9 Prescription Error Rate 38% 18% The majority of prescriptions errors identified were unexplained omissions of previously prescribed medications. After the introduction of the sheets, 84% of case notes included a paediatric medicines reconciliation sheet but only 22% were fully completed. Conclusion There is evidence to suggest the introduction of paediatric medicine reconciliation sheets reduced the paediatric prescription error rate in this district general hospital. Further efforts are needed to ensure all paediatric case notes include a fully completed paediatric medicines reconciliation sheet. The paediatric reconciliation sheet has been redesigned in order to improve its efficacy. This audit is ongoing and is being expanded to other paediatric units via the Scottish Patient Safety Paediatric Programme.