Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)

This study has been terminated.
(Statistical analysis of 153 enrolled Phase 1 patients showed that specific patients could not be targeted for medication histories by discipline.)
Sponsor:
Collaborator:
Cardinal Health Foundation
Information provided by (Responsible Party):
Joan Kramer, Wesley Medical Center
ClinicalTrials.gov Identifier:
NCT01065675
First received: February 3, 2010
Last updated: December 26, 2012
Last verified: December 2012
  Purpose

Up to 50% of medication errors and 20% of adverse drug reactions (ADRs) in the hospital setting are estimated to be related to communication issues regarding patient medications at various transition points of care from admission to discharge. The Joint Commission (TJC) requires accurate and complete medication reconciliation occur at each transition point throughout hospitalization. Evidence from NQF demonstrates pharmacists (RPh) are the most effective medication management team leaders in the implementation of medication management practices and design of medication error reduction strategies; medication reconciliation is one of the five safety objectives pharmacists are recommended to lead. In addition, the Massachusetts Coalition for the Prevention of Medical Errors states strong evidence supports the use of pharmacy technicians (CPhT) in conjunction with pharmacists in completing accurate medication histories.

WMC nurses (RN) currently are involved in the medication reconciliation process. In 2009, a Medication Use Evaluation (MUE) of Medication Reconciliation Accuracy found a 67% medication error rate on admission determined by comparing the nurse-obtained medication history to the pharmacist-obtained medication history. The number of home medications identified by the pharmacist compared to the nurse was 411 versus 312 (p<0.0001). The total percentage of medication errors prevented by the pharmacist was 66.2. Using the VA Healthcare Failure Mode Effects Analysis - HFMEA™ Hazard Scoring Matrix, 3 independent pharmacist reviewers found that 18% of patients interviewed had a score greater than 7, and 3 patients had a score of 12 (major/probable), if the discrepancies would not have been identified and corrected by the pharmacist conducting the admission medication reconciliation audit. The same patients' discharge medication reconciliation and discharge medication lists were retrospectively reviewed for the MUE, and the total percentage of patients with medication errors on discharge was 43%.


Condition Intervention
Medication Reconciliation
Emergency Department
Other: Medication reconciliation completed by a RN, CPhT, or RPh

Study Type: Interventional
Study Design: Intervention Model: Single Group Assignment
Masking: Single Blind (Caregiver)
Primary Purpose: Health Services Research
Official Title: Electronic Patient Triage Development and Implementation Involving Nurse (RN), Pharmacy Technician (CPhT), and Pharmacist (RPh) Obtained Medication Histories in the Emergency Department (ED)and Impact on Medication Reconciliation

Further study details as provided by Wesley Medical Center:

Primary Outcome Measures:
  • To determine which patients benefit most from medication histories obtained by the RN, CPhT, or RPh based on accuracy (% complete disease states, allergy documentation and description, vaccination documentation, medication documentation) [ Time Frame: 5 months ] [ Designated as safety issue: No ]

Enrollment: 153
Study Start Date: February 2010
Study Completion Date: May 2011
Primary Completion Date: April 2010 (Final data collection date for primary outcome measure)
Intervention Details:
    Other: Medication reconciliation completed by a RN, CPhT, or RPh
    To determine which patients benefit the most from medication histories obtained by the RN, CPhT, or RPh. Patients will be admitted as inpatients through the ED with medication histories finalized electronically by the RN at the admitting unit.
    Other Names:
    • Medication Reconciliation
    • Pharmacist
    • Nurse
    • Certified Pharmacy Technician
    • Emergency Department
    • ED
  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients admitted as inpatients from the Emergency Department

Exclusion Criteria:

  • Prisoners (because the IRB does not have a prisoner representative)
  • Patients not admitted as inpatients through the Emergency Department
  • Patients admitted more than once during the study period
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01065675

Locations
United States, Kansas
Wesley Medical Center
Wichita, Kansas, United States, 67214
Sponsors and Collaborators
Wesley Medical Center
Cardinal Health Foundation
Investigators
Principal Investigator: Joan S Kramer, PharmD Wesley Medical Center
  More Information

No publications provided

Responsible Party: Joan Kramer, Clinical Research Pharmacist, Wesley Medical Center
ClinicalTrials.gov Identifier: NCT01065675     History of Changes
Other Study ID Numbers: 09-068
Study First Received: February 3, 2010
Last Updated: December 26, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Wesley Medical Center:
Medication Reconciliation
Emergency Department
Nurse
Pharmacist
Certified Pharmacy Technician
Medication reconciliation: inpatients admitted from the ED

Additional relevant MeSH terms:
Emergencies
Disease Attributes
Pathologic Processes

ClinicalTrials.gov processed this record on October 29, 2014