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Exploring medicines reconciliation in the emergency assessment unit: staff perceptions and actual waiting times.

Authors
  • Ellison, Charlie1
  • Hackett, Katie2
  • Lendrem, Dennis3
  • Abley, Clare4
  • 1 NHS Blood and Transplant Service, Newcastle upon Tyne, England.
  • 2 Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, England and occupational therapist, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England.
  • 3 National Institute for Health Research, Newcastle Biomedical Research Centre, Newcastle upon Tyne, England.
  • 4 Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England and honorary senior clinical lecturer, Population Health Sciences Institute, Newcastle University, England.
Type
Published Article
Journal
Emergency nurse : the journal of the RCN Accident and Emergency Nursing Association
Publication Date
Sep 08, 2020
Volume
28
Issue
5
Pages
28–33
Identifiers
DOI: 10.7748/en.2020.e1988
PMID: 32394649
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Medicines reconciliation is the process of creating and maintaining the most accurate list possible of all medicines a patient is taking. If medicines reconciliation cannot be completed in a timely manner in hospital emergency assessment units (EAUs), delays in treatment can occur, potentially leading to deterioration of long-term and acute conditions, patient distress and complaints. To obtain the perspectives of staff working on an EAU regarding the time patients wait for their medicines to be prescribed, including their awareness of practice and protocols. To determine the time from admission to the EAU until medicines reconciliation, and to identify if there was any time difference in medicines reconciliation according to the day of admission. This was a service evaluation in which staff working in one EAU in a teaching hospital in the north east of England were asked to complete a survey in December 2017. The staff survey aimed to ascertain: whether staff were aware of any guidance relating to medicines reconciliation times; how long they thought the average waiting time was for medicines reconciliation; and if they thought there were implications for patients or staff as a result of time spent waiting for medicines reconciliation. In addition, an audit was performed analysing medicines reconciliation times for all patients admitted to the EAU during the month of December 2017. A total of 30 staff members responded to the survey. While 40% ( n =12) of respondents believed that the EAU had an efficient system in place for timely medicines reconciliation, 90% ( n =27) believed the unit could still improve. Almost half the respondents (47%, n =14) perceived a delay in medicines reconciliation could result in exacerbation of patients' physical conditions. The clinical audit identified considerable variation in medicines reconciliation times, ranging from seven minutes to almost 24 hours. However, most medicines (82%) were reconciled within six hours. This service evaluation found that the median time after arrival in the EAU until completion of medicines reconciliation was two hours 48 minutes. However, almost one fifth of patients had to wait for more than six hours, and in one instance almost 24 hours. One potential solution could be increasing the involvement of hospital pharmacists or pharmacy technicians in medicines reconciliation. © 2020 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

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