Background Research for an effective method of improving quality of home medication reconciliation (HRM) within the surgery unit.
Purpose Validate some indicators for monitoring interventions to improve the quality of HRM on admission to the surgery unit.
Material and methods Observational, descriptive, transversal, pre-post intervention, in patients from a general and digestive surgery unit in a regional hospital, in the last 2 weeks of February and June. The pharmaceutical intervention was agreed on in April and consisted of:
Dissemination of the results of HRM from the pre-intervention period.
Distribution of HRM tasks.
Realisation by surgeons of HRM of regulated patients, with the possibility of exceptionally requesting ‘HRM by pharmacy’, by using this command in the electronic prescribing programme.
Realisation by the surgery unit responsible pharmacist of HRM of emergency surgery patients (pending validation by the surgeon), by selecting patients from the list of admissions of emergencies.
Percentage of surgical admissions, and records of HRM (regulated and urgent surgical patients).
Percentage of patients needing HRM (without registration, with full or partial registration record).
Percentage of reconciliation of: heparins and oral anticoagulants; oral antidiabetics (OAD) and insulins; and antihypertensives.
Sources consulted (Software-Diraya) (Software-Specialised-Care-DAE) (Unidosis-Landtools).
A descriptive analysis as a percentage of the variables used is performed. For comparison the χ2 test was used.
Results 184 patients (92 pre-intervention and 92 post-intervention).
Patients who needed HRM pre-intervention: 67% (16% without HRM registration; 27% total registration and 24% partial registration).
Patients who needed HRM post-intervention: 71% (3% without HRM registration and 68% with HRM registration – 41% total and 27% partial).
We increased from 74.19% of patients needing HRM, reconciliated in the pre-intervention period, to 95.52% in the post-intervention period (significant increase, p = 0.001) (EPIDAT 4.1). Time to HRM median (interquartile range) decreased from 2 days (1–6) to 1 day (1–3).
Reconciliation of antihypertensives Increased from 64% to 96%, OAD/insulins from 77% to 96% and anticoagulants from 100% to 100%.
Conclusion These indicators are useful to regularly monitor quality of HRM. This is demonstrated by the effectiveness of monitoring data dissemination, and distribution of HRM tasks in a team.
References and/or Acknowledgements Juan Manuel Praena Fernandez. Statistics
No conflict of interest.
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