Shared charts for prescription and administration: Increasing safety of drug treatment

Article type: Research Article

Authors: Bourke, Jill | Bjeldbak‐Olesen, Inger | Nielsen, Per Mikael | Munck, Lars Kristian

Affiliations: Department of Medicine and Orthopaedic Surgery, Køge Hospital, DK‐4600 Køge, and Roskilde County Hospital Pharmacy, DK‐4000 Roskilde, Denmark

Note: [] Address for correspondence: Lars Kristian Munck, MD, DM Sci, Department of Medicine, Køge Hospital, DK‐4600 Køge, Denmark. E‐mail: mulk@dadlnet.dk.

Abstract: Introduction: Medication errors contribute up to 8% of all hospital admissions. Minimising the number of information transferrals and improving communication may increase the quality of drug treatment. Material and methods: The effect of introducing shared charts for prescription and administration on the quality of drug handling in a hospital was evaluated using chart review and observation of medicines administration. Results: Comparison of prescriptions in hospital records and nurse charts for medicines administration for 20 patients prior to introducing common charts revealed in no case consensus regarding all medications. One year after introducing the shared charts prescriptions of the regular and on demand medication were correct and signed for 88% and 48%, respectively, on a patient basis. Ninety‐five percent of the regular administrations were correct and signed. Potential interactions were identified with 8% of the prescriptions. Discharge medication was stated in 65% of the discharge letters to the family doctors. Complete agreement on admission medication between the patient and family doctor was found in 39%. Conclusion: Shared charts for prescription and administration represent a significant step towards safe and rational medical treatment. However, it is more time consuming. The thorough analysis increased the attention on all aspects of medicine handling. It also provided a firm basis for the succeeding detailed specification of a complete integrated and electronic handling of all aspects of the medication process. Improvement of communication between all parties involved in treatment of the same patient represents an important potential for further improving quality and safety of drug treatment.

Journal: International Journal of Risk and Safety in Medicine, vol. 15, no. 3-4, pp. 183-191, 2002