Facilitating medication misadventure risk assessment in the emergency medical unit

Kumar, N; Knowler, CB; Strumpman, D; Bajorek, BV

Facilitating medication misadventure risk assessment in the emergency medical unit

Kumar, N Knowler, CB Strumpman, D Bajorek, BV

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Publication Type:: Journal Article
Citation:: Journal of Pharmacy Practice and Research, 2011, 41 (2), pp. 108 - 112
Issue Date:: 2011-01-01

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Field	Value	Language
dc.contributor.author	Kumar, N	en_US
dc.contributor.author	Knowler, CB	en_US
dc.contributor.author	Strumpman, D	en_US
dc.contributor.author	Bajorek, BV https://orcid.org/0000-0002-2532-7187	en_US
dc.date.issued	2011-01-01	en_US
dc.identifier.citation	Journal of Pharmacy Practice and Research, 2011, 41 (2), pp. 108 - 112	en_US
dc.identifier.issn	1445-937X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/31637
dc.description.abstract	Background: The risk of medication misadventure is heightened in emergency settings. Identifying at-risk patients is integral to minimising medication-related adverse events. Aim: To pilot a medication misadventure risk assessment tool to identify at-risk patients most likely to benefit from targeted intervention by an emergency department pharmacist. Method: A prospective descriptive study was undertaken in an emergency medical unit over 2 weeks (June to July 2009). Patients were included if they were over 70 years of age, took 3 5 regular medications, had 3 3 comorbidities, and/or were newly started on warfarin or had been admitted to the emergency department as a result of a medication-related adverse event. Nurses were encouraged to use the medication misadventure risk assessment tool for all patients admitted to the emergency medical unit. The pharmacist provided targeted interventions to all patients who were identified as being at-risk by the nurses. The pharmacist also verified the accuracy of the risk assessments undertaken by the nurses using this tool. Main outcome measures were the sensitivity and specificity of the tool and the reliability of the nurses' risk assessment. Results: Nurses completed 115 medication risk assessments for 194 patients. The risk assessments were accurately completed in all but 10 patients. Of the 36 (31%) patients assessed as high risk, 18 required pharmacist intervention. Of the 79 patients assessed as low risk, 3 required pharmacist intervention. The tool was useful in identifying at-risk patients (specificity 78%, 95%CI 69-85; sensitivity 83%, 95%CI 60- 94). Conclusion: Nurses in the emergency department used the risk assessment tool to identify patients at risk of medication misadventure and facilitate targeted interventions by pharmacists.	en_US
dc.relation.ispartof	Journal of Pharmacy Practice and Research	en_US
dc.relation.isbasedon	10.1002/j.2055-2335.2011.tb00675.x	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.title	Facilitating medication misadventure risk assessment in the emergency medical unit	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	41	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	closed_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	41	en_US

Abstract:

Background: The risk of medication misadventure is heightened in emergency settings. Identifying at-risk patients is integral to minimising medication-related adverse events. Aim: To pilot a medication misadventure risk assessment tool to identify at-risk patients most likely to benefit from targeted intervention by an emergency department pharmacist. Method: A prospective descriptive study was undertaken in an emergency medical unit over 2 weeks (June to July 2009). Patients were included if they were over 70 years of age, took 3 5 regular medications, had 3 3 comorbidities, and/or were newly started on warfarin or had been admitted to the emergency department as a result of a medication-related adverse event. Nurses were encouraged to use the medication misadventure risk assessment tool for all patients admitted to the emergency medical unit. The pharmacist provided targeted interventions to all patients who were identified as being at-risk by the nurses. The pharmacist also verified the accuracy of the risk assessments undertaken by the nurses using this tool. Main outcome measures were the sensitivity and specificity of the tool and the reliability of the nurses' risk assessment. Results: Nurses completed 115 medication risk assessments for 194 patients. The risk assessments were accurately completed in all but 10 patients. Of the 36 (31%) patients assessed as high risk, 18 required pharmacist intervention. Of the 79 patients assessed as low risk, 3 required pharmacist intervention. The tool was useful in identifying at-risk patients (specificity 78%, 95%CI 69-85; sensitivity 83%, 95%CI 60- 94). Conclusion: Nurses in the emergency department used the risk assessment tool to identify patients at risk of medication misadventure and facilitate targeted interventions by pharmacists.

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http://hdl.handle.net/10453/31637