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4CPS-041 Silence speaks louder than words: omission of prescription in the emergency room
  1. A Morales Portillo,
  2. M Mir Cros,
  3. M Bardoll Cucala,
  4. M Cuy,
  5. A Galindo Verdugo,
  6. C Santos Rodriguez,
  7. B Martinez Castro,
  8. I Mangues Bafalluy,
  9. JA Schoenenberger Arnaiz
  1. Hospital Universitario Arnau de Vilanova, Farmacia, Lleida, Spain


Background and Importance Medicines reconciliation is the process of accurately listing a person’s current medicines. This is recommended when admitted into a service or treatment changes. The Emergency Room (ER) is one way from primary health care to secondary and tertiary; as such, medicine reconciliation plays a critical role. Electronic prescription allows the tracking of prescriptions during the admission of patients to the ER.

Aim and Objectives This project aimed to assess the current situation regarding medicines reconciliation during ER admission and to estimate the degree of electronic prescription omission in the ER.

One hundred patients were registered The exclusion criteria was discharge time inferior to 4 hours after admission.

Over 10 consecutive work days, 10 patients were chosen every day in the following manner: The five most recent patients admitted to the ER during the night shift (0–8 am) and the first five patients admitted during the morning shift (8 am to 3 pm).

Current medicines for each patient were obtained from electronic records prior to admission, current medical visit and, in case of doubt, direct patient interview.

Sex, age and omission between electronic prescription in the ER and each patient’s current medicines were registered.

Omissions were considered justified when omitted medicine was the reason to visit the ER, acute clinical situations made the medicine contraindicated, and there was a significant interaction (level D or X) between the omitted medicine and any medicine or process indicated during the admission.

Omitted medicines were sorted out by ATC group of active principle.

Results Among the 100 patients, 47 were women, and 53 were men. Age was 66.5 ± 21.4 years.

Out of 100 patients, 71 had errors in their electronic prescriptions, resulting in 121 omissions. Of these omissions, 61 (50.4%) were classified as unjustified. Medicines fell into ATC groups by C (41%, 25), N (27.9%, 17), B (11.5%, 7), S (9.8%, 6), R (4.9%, 3), A (3.3%, 2) and J (1.6%, 1).

Conclusion and Relevance Omissions of prescriptions, particularly for cardiovascular and nervous system medications, are common in our hospital’s ER. This issue must be addressed as it may result in negative clinical outcomes.

Conflict of Interest No conflict of interest.

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