The National Institute for Health and Clinical Excellence (NICE) in collaboration with the National Patient Safety Agency (NPSA) has issued guidance to the NHS on how to improve processes to ensure that any medication patients are taking prior to admission to hospital is properly documented on admission.
Prescribing errors can result in harm to patients and the aim of medicines reconciliation when patients are admitted to hospital is to ensure that important medicines aren’t stopped and that new medicines are prescribed, with a complete knowledge of what a patients is already taking. The NPSA has reported the number of incidents of medication errors involving admission and discharge as 7070 with 2 fatalities and 30 that caused severe harm (figures from November 2003 and March 2007).
To improve medicines reconciliation at hospital admission NICE/NPSA has recommended that: All healthcare organisations that admit adult inpatients should make sure that they have policies in place for medicines reconciliation on admission. This includes mental health units, and applies to elective and emergency admissions.
In addition to specifying standardised systems for collecting and documenting information about current medications, policies for medicines reconciliation on admission should ensure that:
pharmacists are involved in medicines reconciliation as soon as possible after admission.
Dr John Pounsford, Patient Safety Advisory Committee member, said: “Remembering what medication they are taking is not always the first priority for patients coming into A&E, they may be in pain or disoriented and the main priority for healthcare professionals is to treat the symptom. It can therefore be very difficult to get an accurate picture of a patient’s medication upon hospital admission. It is very important for pharmacists and their teams to cross check what the patient tells them with their GP and their carer to get an accurate record.”
