A Sydney pilot study has found pharmacist medication charting significantly reduced errors—a finding that could pave the way for future prescribing
A trial of a pharmacist charting service in a Sydney teaching hospital has gained some positive insights into preadmission pharmacist involvement.
The study involved a one-month baseline audit of medication charting, followed by a one-month trial of pharmacist charting, which involved preparing patients’ medication charts during routine consultations.
In addition to data collection, clinical staff members were asked to provide feedback about the service.
Seventy-two medication charts were completed by preadmission clinic pharmacists during the one-month trial.
Post intervention, completeness of charts shot up from 5.4% pre intervention to 80.6% post intervention (p < 0.001).
Accuracy of the charts also improved, with the proportion of charts with inaccuracies lowering from 41.1% pre-intervention to 1.4% post-intervention (p < 0.001).
Only one (1.4%) pharmacist-prescribed medication chart was identified as having an inaccuracy, which was an error citing the generic name of a branded product.
When medication charts were followed up post-operatively, no amendments (0%) to the pharmacist-charted medications were identified.
“The findings highlight that a pharmacist charting service leads to increase completeness of medication charts, utilising pharmacists’ specific knowledge and skills in obtaining a more accurate and comprehensive medication history,” say the authors from the UTS Graduate School of Health (Pharmacy), University of Sydney Faculty of Pharmacy, and Royal North Shore Hospital.
Studies have shown that incomplete medication charts contribute significantly to medication errors in hospitals.
Accuracy of medication charts is “the most important aspect of charting, since an inaccurate medication chart may initiate a cascade of many medication errors in hospitals,” they add.
Most respondents of a staff survey said they “strongly agreed” that pharmacists conducting the service were “competent and adequately skilled to chart medications”.
There was also strong agreement that pharmacist charting had increasing accuracy and completeness of charts.
Staff members noted the service led to decreased workloads for both doctors and ward pharmacists.
The main cited disadvantage was the time spent by nurses on following up doctors when they forgot to sign charts (as they were required to sign the charts twice).
Almost all participants suggested the service could also be improved by employing more pharmacists “to lighten load on a busy day”.
There is potential for pharmacist prescribing to help bridge the gap between medication history-taking and prescribing, argue the authors.
While yet to be fully implemented in Australia, pharmacist prescribing within the context of preadmission clinics may prove to particularly beneficial and efficient, they say.
“From a clinical practice perspective, this study could lay the foundation for the implementation of pharmacist prescribing at other points of entry to the hospital, and may serve as a model for pharmacist prescribing in the community.”