Extending pharmacy services to the point of discharge

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Abstract

Aim The aim of this study was to determine the impact of introducing a clinical pharmacist led discharge service on medication safety at the point of discharge and its acceptability to healthcare staff. Methods A retrospective chart review to identify medication discrepancies was undertaken before and after the introduction of a pharmacist led discharge service. An evaluation was undertaken by means of a questionnaire to community pharmacists, GPs and hospital clinicians. Results The pharmacist led discharge service significantly reduced errors from 50% (n=17) to 7% (n=2) of patients (p<0.001) and 10% (n=22) to 1% (n=2) of medication orders (p=0.001). The evaluation revealed that the majority of clinicians found the service useful, had the potential to reduce errors and improve communication. Conclusion Pharmacist involvement at the point of discharge had a significant impact on medication safety. Crucially, in this project, we show the service was received well by medical personnel and improved communication between primary and secondary care, enhancing implementation potential.

Original languageEnglish
Article numberP235
Pages (from-to)1-9
Number of pages9
JournalIrish Medical Journal
Volume114
Issue number1
Publication statusPublished - Jan 2021

Keywords

  • Medication error
  • Medication reconciliation
  • Pharmacy
  • Point of discharge
  • Safety

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