Background In the paediatric surgery unit (38 beds), due to the multiplicity of prescribers (anaesthetists and surgeons) and to the parents’ presence who are accustomed to looking after their child’s medications, the management of patients’ home medications is a critical point. The two main specialties of the unit are orthopaedic and visceral surgeries. A clinical pharmacy team has been deployed in the unit in April 2018 to improve medication safety.
Purpose To assess the impact of the pharmaceutical team in the unit.
Material and methods The pharmaceutical team undertook three main missions:
Medication reconciliation (MR) for patients undergoing treatment: before admission for planned patients and after admission for non–planned patients. These patients were identified thanks to the anaesthetist consultation or the electronic record.
MR on transfer to the rehabilitation centre, if necessary.
Medication review during hospitalisation.
Since April, every pharmaceutical intervention (PI) has been registered and categorised according to the French Society of Clinical Pharmacy classification.
Results Over the past 6 months, the team realised 321 MRs on admission; 60 MRs on transfer to the rehabilitation centre; and all the prescriptions were reviewed daily from Monday to Friday.
Thirty-seven per cent of planned patients and 11% of non-planned patients had an undergoing treatment before their admission.
The team realised 163 PIs concerning 120 patients, throughout medication review or MR. These PIs mainly concerned omitted medication (46%), incorrect posology (33%) and inadequate use (13%). A PI has been recorded for 20% of patients for whom the medications were reconciled.
According to the Anatomic, Therapeutic and Chemical classification, the most represented classes were A: alimentary tract and metabolism (29%); N: nervous system (26%); R: respiratory system (13%); and J: antiinfectives for systemic use (11%).
Conclusion This analysis highlights that about one-quarter of children have a current medication on admission. It is important to focus on those patients to be effective. Considering the number of PIs, the work of the pharmaceutical team, together with the medical team, is essential in securing patients’ healthcare and achieve continuity in medication management.
References and/or acknowledgements 1. Mocquard J, et al. A regional resource center to promote and develop medication reconciliation: missions and helping tools. J Pharma Clin https://www.jle.com/en/revues/jpc/e-docs/creation_dun_centre_de_ressources_en_conciliation_medicamenteuse_presentation_dune_initiative_regionale_pour_le_deploiement_de_lactivite_312336/article.phtml
No conflict of interest.