1211 / Implementing medication reconciliation

ITALY
Classification of the PSP
Type of Patient Safety Practice Potentially Safe
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Identification of risk and harm
Implementation of Patient Safety initiatives / Activities There is no specified text here
Topic of the reported practice
Quality improvement project
Aim and the benefit of the Patient Safety Practice
 
Medication reconciliation is a formal process of cooperation between health professionals and patients, their relatives and care-givers, in order to thoroughly detect and achieve a complete and accurate list of patient’s current medications, together with other information related to the patient. In so doing the prescribing physician should carefully assess whether to continue the therapy, modify or stop it, in whole or in part. The first step is medication recognition, that means collecting the most complete and accurate list of information on medications and other products taken by patients, together with other information related to the main aspects of patient’s medication history (i.e. allergies). An accurate medication reconciliation is therefore a crucial step to ensure safe prescription of therapies and subsequent appropriate treatments. In 2006, World Health Organization (WHO) prioritized medication reconciliation as a top strategy for patient safety. It recommended core interventions to reduce risks of adverse events due to inappropriate information on current therapies. Almost 20% of all adverse drug events are due to poor communication, change in healthcare setting and different care interactions. Medication reconciliation at hospital admission is undoubtedly one of the most critical steps in the process: checking all medications a patient is taking require an interview with patient himself and / or his care-giver, other sources of information, a visual check of medications taken by patients. At Santa Maria Nuova Hospital, the effort to set up an effective medication reconciliation required the use of quality improvement tools, in order to create a Recognition form, suitable to Santa Maria Nuova Hospital clinical, organizational and technological environment and allowing healthcare staff: • to get an exhaustive and accurate list of patient’s medication information (conventional and alternative) and other information; • to support the decision making process in medical prescription, thanks to increased accuracy and knowledge in treatment management; • to meet safety requirements laid down by Santa Maria Nuova Hospital procedures, as far as medication reconciliation is concerned.
Description of the Patient Safety Practice
 
A multidisciplinary team was set up in January 2013. It included hospital risk manager, nurse risk manager and members of medical, nursing and pharmaceutical staff. Santa Maria Nuova Hospital multidisciplinary team drew up a special program on medication reconciliation to be developed by Medical Oncology Unit. From the very beginning, the program was introduced to all professionals involved. It included: • a retrospective analysis on medical reports, in order to verify whether medication reconciliation had been already performed even without specific tools and only as a result of dissemination of Hospital “Clinical Governance of Drugs” and of specific training on risk management and medication reconciliation; • development of a Medication Recognition Form, to be attached to medical record, taking into account the main critical conditions and improvement options coming from the first analysis; • employmnent of Medication recognition form, for all patients hospitalized at Medical Oncology Unit, as a tool of clinical practice for all professionals (unit doctors and emergency ward doctors); • assessment of the use and effectiveness of Medication recognition form, in order to improve patient safety, thanks to a new retrospective analysis; • distribution of this improved tool to other Hospital Units assimilated to Medical Oncology Unit, as far as organizational model and patients’ attributes are concerned.
Clinical audit was performed in order to assess the results. Preparatory clinical audit (years 2013-2014) and audit on the development of improvement actions (years 2015-2016) were reshaped, according to the template set up by the Emilia Romagna Region as far as Safety Program on clinical management of drugs (two year period 2013-2014) is concerned. Starting from preparatory clinical audit (2013-2014), medication reconciliation and clinical history focused on allergies turned out to be systematically disseminated in patients taking into account (n = 220) at Medical Oncology Unit (96% and 97% of cases respectively). However, the analysis outlined some improvement steps, as far as clear and thorough information on drugs is concerned, together with records dealing with source of information on patient therapeutic history. The results were introduced to hospital authorities and staff involved in the project. Improvement steps were jointly discussed and led to Medication recognition form thanks to the help of clinicians and multidisciplinary team. Since July 2014, Medication recognition form has been used at Medical Oncology Unit, where it is at present under examination, in order to assess whether this tool actually produced improvement in patient safety, in particular in the areas outlined by preparatory clinical audit. Dissemination of Medication recognition form to other hospital units will take place by attaching it to patient electronic medical record for a medication reconciliation which will take into account the results of the last assessment step.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
No
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Pharmacists
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/questionnaire.aspx?id=5234
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Staff and management recognised the need for change
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Annamaria Valcavi
Country: ITALY
Organisation: ARCISPEDALE S. MARIA NUOVA
E-mail: annamaria.valcavi@asmn.re.it
Phone: There is no specified text here
Print
Top
At la sikisen cesaretli kadina 50 cm at yarragi giriyor hayvanli porno izle
sirinevler escort sirinevler escort atakoy escort mecidiyekoy escort etiler escort atasehir escort capa escort
usak escort elazig escort
sex filme
porno
sirinevler escort beylikduzu escort atakoy escort sisli escort atakoy escort sisli escort sirinevler escort beylikduzu escort halkali escort halkali escort istanbul escort beylikduzu escort beylikduzu escort sirinevler escort sirinevler escort beylikd�z� escort �i�li escort �irinevler escort avrupa yakasi escort �apa escort beylikd�z� escort