Discharging patients with prescriptions

medications: sequelae in a teaching hospital.

Authors: Johnson, Kevin B.; Butta, Jeanne K.; Donohue, Pamela K.;

Glenn, Donald J.; Holtzman, Neil A.

Citation: Pediatrics, April 1996 v97 n4 p481(5)

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Abstract: Pediatric patients discharged from the hospital with unfilled

prescriptions appear to be subject to significant medication

errors. Researchers compared the prescription labels,

discharge instruction sheets (DCIs), and medication labels

from 335 prescriptions for 192 patients who were discharged

from an academic children's hospital. Forty discrepancies were

found in this information, giving a 12% error rate for

medication. These errors affected 19% of the patients. Of the

discrepancies, 19 were from original prescription errors, 3

resulted from a different concentration or strength in the

medication provided, 12 had mistakes in the DCI, and 6 were

from differences between the medication label and the

prescription. Pharmacists provided advice about medication to

44% of the patients' families. Filling prescriptions before

discharge, so that they may be checked by health care

providers, may decrease the occurrence of these errors.

. . .
e discharged. This new discharge process is contrasted with our typical process, as shown in the Figure. The purpose of our study was to document the extent of and reasons for differences among prescriptions written by our residents and interns, discharge instruction sheets (DCIs) created by our nursing staff, and medications dispensed by community pharmacists. Our main objective was to determine the potential benefit that quality improvement initiatives, such as those adopted by our NICU, might have on the accuracy of discharge teaching done in our other inpatient units. METHODS The study was conducted in the infant, child, and adolescent units of the Johns Hopkins Hospital during August and October 1993. Nurses and clerks in the study units were instructed to place a copy of each DCI and prescription in a specially provided box. During the study period, we collected the copies of prescriptions and DCIs from the study units. The DCI was used to collect data about the patient's age and admitting service (surgery versus pediatrics), as well as to obtain the medication instructions given to the family. We then contacted the patients' care givers (usually, the parents) by telephone and asked them to read the
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Approximate Word count = 3731
Approximate Pages = 15 (250 words per page)