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PS-037 New forms to improve the pre-operative prescription
  1. L Gutermann1,
  2. D Christensen2,
  3. R Haddad1,
  4. S Roy1
  1. 1Hôpital Antoine Béclère, Pharmacy, Clamart, France
  2. 2Hôpital Antoine Béclère, Anaesthesia Department, Clamart, France

Abstract

Background In our hospital, planned interventions concern 40% of patients coming for orthopaedic and abdominal surgery. All of them have to have filled in an information sheet, one part of which focuses on their personal medicines. During the pre-anaesthetic consultation, a consultation form (SC) is filled in by the anaesthetist and is currently used as reference for pre-operative prescriptions. The occurrence of a vitamin K antagonist administration error called into question the use of these forms.

Purpose To reassess the current personal medicines forms in order to define ways of improvement.

Materials and methods First, we mapped out the drug path of patients coming for a planned intervention (DPP). Then, a one-month prospective study was conducted to evaluate both the information sheet filling rate by patients and the quality of SC filling by anaesthetists. The acceptance criteria were: no abbreviations, information entered in the boxes provided, administration boxes ticked, dose and administration plan documented. All patients with at least one medicine were included.

Results Mapping the DPP allowed us to identify all the health professionals involved in the patient’s clinical pathway and the forms used to get information on patients’ personal medicines. 30 patients were included in the survey, which corresponded to 104 lines of medicines. Only 63% of the audited records included the information sheet, and of these only 83.3% of the medicines boxes had been completed by patients.

Regarding the quality of the SC filling, although no abbreviations were observed, 63.3% of boxes related to the administration were unticked, 44.2% of doses were absent, 16.4% of data were not filled in in the appropriate boxes, 11.5% of administration plans were incomplete or missing. These high rates of unacceptable completion could lead to administration errors and emphasise the inadequacy of the current form in daily practice.

Conclusions Analysis of unacceptable standards of form completion and the DPP during multidisciplinary meetings (surgeons, anaesthetists, nurses, pharmacists) has led to improvements: the SC and the information sheet have been modified, ‘bring your prescribed medicines’ is now written on the sheet which confirms the appointment with the anaesthetist and health professionals will be trained before the new forms are introduced. Finally, a review is planned following the changes made.

No conflict of interest.

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