Background Medication errors commonly occur at transition points in patient care, particularly on admission to hospital.
Medicines reconciliation is the process of identifying the most accurate list of a patient’s current medicines and it should be done before the first 24 hour after admission.
The participation of pharmacists in obtaining an accurate medication history for hospitalised patients is a key point in improving the process of reconciliation.
Purpose Evaluate the benefits of the introduction of a pharmacist into the Emergency Department (ED) to improve the reconciliation process.
Material and methods A prospective intervention study (2016–2017). The medication was reconciled at two different times and places: in admission to the geriatric ward (2016) and the admission to the ED (2017).
Patients older than 65 years and six or more drugs admitted to the ward were included. A target was set that ideally 100% of patients admitted would have their medications reconciled within 24 hour of admission.
To calculate the percentage of patients reconciled within 24 hour, the total number of patients who met the inclusion criteria for conciliation were collected. We did not collect data on Saturdays or Sundays. For the inferential statistics, the Chi-square test was used.
Results A total of 394 patients was reconciled, 106 patients in the ward for the first time and 288 patients in the ED for a second time.
The percentage of patients with their medicines reconciled by a pharmacist within 24 hour of admission increased from 38% in the ward to 83% in the ED, and was significant (p<0.001).
The lack of weekend cover resulted in not meeting the target of 100% of patients having medication reconciliation complete within 24 hour of admission.
For those patients in the ED who had been admitted medically but awaited a bed on a ward for a number of hours, the opportunity for their medicines to be reconciled within 24 hour was greatly reduced in the absence of an ED pharmacist.
Conclusion The presence of an ED pharmacist improves the number of patients who have their medicines reconciled within 24 hour of admission.
Since this initial project, we must continue working to expand the role of the clinical pharmacist further and to provide an extended pharmacy service to both hospital staff and patients.
References and/or acknowledgements No conflict of interest.
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