Medication reconciliation: a practical tool to reduce the risk of medication errors
Abstract
Preventable adverse drug events are associated with one out of five injuries or deaths. Estimates reveal that 46% of medication errors occur on admission or discharge from a clinical unit/hospital when patient orders are written. This study was performed to reduce medication errors in patient's discharge orders through a reconciliation process in an adult surgical intensive care unit (ICU). A discharge survey was implemented as part of the medication reconciliation process. The admitting nurse initiated the survey within 24 hours of ICU admission and the charge nurse completed the survey on discharge. Baseline data were obtained through a random sampling of 10% of discharges in first 2 weeks of the study (July 2001-May 2002). Medical and anesthesia records were reviewed, allergies and home medications verified with patient/family and findings compared with orders at time of ICU discharge. Baseline data revealed that 31 of 33 (94%) patients had orders changed. By week 24, nearly all medication errors in discharge orders were eliminated. In conclusion, use of the discharge survey in this medication reconciliation process resulted in a dramatic drop in medications errors for patients discharged from an ICU. The survey is now a part of our electronic medical record and used in 4 adult ICUs and 2 medicine floors.
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A 2017 single-center before-and-after study reported shorter duration of vasopressor therapy and lower mortality following administration of high-dose vitamin C, hydrocortisone, and thiamine to patients with sepsis and septic shock.
“In 2017, a single center before and after study reported shorter duration of vasopressor therapy and lower mortality following the administration of combination of high dose vitamin C, hydrocortisone, and thiamine to patients with sepsis and septic shock (521).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [521]
Medication reconciliation has been associated with fewer medication errors and may help reduce hospital readmission.
“Medication reconciliation has been associated with fewer medication errors [598, 612] and may help reduce hospital readmission [613, 614].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [612]
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- Authors
- Pronovost, P., Weast, B., Schwarz, M., Wyskiel, R. M., Prow, D., Milanovich, S. N., Berenholtz, S., Dorman, T., & Lipsett, P.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Pronovost, Peter
- Venue
- Journal of Critical Care
- Publisher
- Elsevier BV
- Published
- 2003-12
- Volume
- 18
- Issue
- 4
- Pages
- 201-205
- ISSN
- 0883-9441 (ISSN-L)
- OpenAlex
- W2137815358
- Cited by
- 371
- References
- 20
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 11 · 2023: 11 · 2022: 12 · 2021: 12 · 2020: 12 · 2019: 13 · 2018: 18 · 2017: 23 · 2016: 15 · 2015: 27 · 2014: 17 · 2013: 20 · 2012: 20
- FWCI
- 17.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Critical Care (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- medication reconciliation, medication errors, adverse drug reactions, intensive care unit discharge, surgical intensive care unit, electronic health records, medication orders, patient safety
- MeSH terms
- Continuity of Patient Care, Hospitals, University, Humans, Intensive Care Units, Medication Errors, Medication Systems, Hospital, Patient Care Team, Patient Transfer, Quality Assurance, Health Care
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