HHE Emergency and critical care 2019 | Page 18

FIGURE 6 Total dose omissions (ED and first 24 hours of base ward admission) Pharmacist Number Total due Total Total Total % doses % doses of patients on time delayed omitted omitted omitted Intervention or delayed No 70 407 265 36 106 26.0* 34.9* Yes 19 105 96 5 4 3.8* 8.6* Total 89 512 361 41 110 21.5 29.5 *p<0.05 FIGURE 7 Total dose omissions within first 24 hours of admission (excluding ED stay) Pharmacist Number Total due Total Total Total % doses % doses of patients on time delayed omitted omitted omitted Intervention or delayed No 20 74 57 6 12 16.2* 24.3* Yes 69 307 255 17 35 11.4* 16.9* Total 89 381 312 22 47 12.3 18.1 *p>0.05 Medication prescribing errors were detected in a total of 16 cases where APMs were prescribed in the ED. These errors related to inappropriate dose, frequency or formulation of the medication. A further four of these cases that had pharmacist intervention had errors corrected immediately, with patients not receiving any incorrect doses. Discussion The results demonstrate the potential impact of a consistent pharmacy presence on this high-risk population of patients. Furthermore, these findings lend weight to previous studies highlighting EDs as high-risk environments. Lastly, clear risk has been identified of patients deteriorating from baseline as a result of delayed medicines reconciliation within ED. Baseline demographics and admissions A total of 151 patients were identified and analysed who suffered from PD throughout the two-month study period. Of these, 89 (58.9%) required inpatient admission. This figure more than doubles the approximate average percentage internally of all patients who require inpatient treatment (26%). The average age of approximately 80, reflects a considerably older population of patients suffering from PD. This finding is generally consistent with literature, considering patients suffering from PD FIGURE 8 Total length of inpatient stay vs percentage of doses missed in ED and the first 24 hours of inpatient admission % dose omitted % doses omitted or delayed Linear (% doses omitted) 45 40 35 30 25 20 15 10 5 0 <24 hours 1-3 days 4-7 days 1-2 weeks 2-4 weeks 1-2 months 18 HHE 2019 | hospitalhealthcare.com 2 months+ 45 40 35 30 25 20 15 10 5 0