Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)
Primary Purpose
Medication Reconciliation, Emergency Department
Status
Terminated
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Medication reconciliation completed by a RN, CPhT, or RPh
Sponsored by

About this trial
This is an interventional health services research trial for Medication Reconciliation focused on measuring Medication Reconciliation, Emergency Department, Nurse, Pharmacist, Certified Pharmacy Technician, Medication reconciliation: inpatients admitted from the ED
Eligibility 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
Sites / Locations
- Wesley Medical Center
Outcomes
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)
Secondary Outcome Measures
Full Information
NCT ID
NCT01065675
First Posted
February 3, 2010
Last Updated
December 26, 2012
Sponsor
Wesley Medical Center
Collaborators
Cardinal Health
1. Study Identification
Unique Protocol Identification Number
NCT01065675
Brief Title
Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)
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
Study Type
Interventional
2. Study Status
Record Verification Date
December 2012
Overall Recruitment Status
Terminated
Why Stopped
Statistical analysis of 153 enrolled Phase 1 patients showed that specific patients could not be targeted for medication histories by discipline.
Study Start Date
February 2010 (undefined)
Primary Completion Date
April 2010 (Actual)
Study Completion Date
May 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Wesley Medical Center
Collaborators
Cardinal Health
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
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%.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Medication Reconciliation, Emergency Department
Keywords
Medication Reconciliation, Emergency Department, Nurse, Pharmacist, Certified Pharmacy Technician, Medication reconciliation: inpatients admitted from the ED
7. Study Design
Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
Care Provider
Allocation
N/A
Enrollment
153 (Actual)
8. Arms, Groups, and Interventions
Intervention Type
Other
Intervention Name(s)
Medication reconciliation completed by a RN, CPhT, or RPh
Other Intervention Name(s)
Medication Reconciliation, Pharmacist, Nurse, Certified Pharmacy Technician, Emergency Department, ED
Intervention Description
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.
Primary Outcome Measure Information:
Title
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
10. Eligibility
Sex
All
Accepts Healthy Volunteers
No
Eligibility 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
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joan S Kramer, PharmD
Organizational Affiliation
Wesley Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wesley Medical Center
City
Wichita
State/Province
Kansas
ZIP/Postal Code
67214
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Medication Histories Conducted by Nurses (RNs), Pharmacy Techs (CPhTs) & Pharmacists (RPhs)
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