The Development of Medication Reconciliation System in Pediatric Patients by using Computerized Program at Queen Sirikit National Institute of Child Health
Keywords:
Medication reconciliation, Medication errors, Pediatric patientsAbstract
Background: Medication reconciliation (MR) has been identified as an important process to prevent medication errors at transitions of care. The pharmacist completed all process of MR, but did not cover all wards and all care transitions due to time limitation. Objective: To develop MR system by using computerized program on admission and discharge, and to evaluate MR system in pediatric patients at Queen Sirikit National Institute of Child Health. Method: This descriptive study was designed to determine the development of MR computerized program. Medication data of patients was collected between October 1st 2017 to September 30th 2018. The coverage of MR program and medication errors were analyzed by descriptive statistics. Result: It was found that 15,357 patients admitted, 96.58% had been approached through MR computerized program and 95.22% were taken within 24 hours. Most of them (77.71%) had no medication use before admission. About 15,317 discharge patients, 75.61% had been approached through MR computerized program. Those were 50.71% of the patients used medicine 1 – 5 times during discharge. Medication errors were found in 145 patients (171 medications) on discharge more than admission. The highest proportions of medication errors were due to wrong dose (67.59%), followed by omission error (26.90%). After the errors were found, pharmacist consulted physicians to correct prescriptions for all patients (100%). Therefore, all of medication errors were in category B (100%). The most errors were found in the medication that used in respiratory tract (25.15%), gastrointestinal tract (21.05%), and nervous system (14.62%). Conclusion: The development of MR system in pediatric patients using effective computerized program and the coverage of process on admission and discharge within an appropriate time can prevent potential medication errors. Due to computerized program, MR process was completed on time and covered all wards. Therefore, MR is an essential process to confirm the safety of medication use in patients.
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