Authors (including presenting author) :
Li CL(1), Tsang LF(1), Wong CK(1), Kong CY(1), Cheng HC(1)
Affiliation :
(1)Orthopaedics and traumatology, United Christian Hospital
Introduction :
Medication errors defined as failure in the treatment process that lead to or has the potential to lead to harm to patients (Ferner and Aronson 2006). Medication errors commonly occur when patients transfer from hospital to home (Forster et al., 2003). Other issues including missing various specialties’ appointments and investigations are occasionally occurred upon patient discharge. Medication errors and non-compliance of appointment can lead to increase the rate of re-hospitalization (Coleman et al., 2005).
Objectives :
This project aims to design a systematic checklist to have a better preparation of patients’ discharge care and better communication among nurses and clerical staff.
Methodology :
The common areas requiring for patient discharge were gathered among nurses and analysed to develop a systematic checklist. It was circulated to several senior nurses conveniently for comments. A self-administered questionnaire was given to all nurses to get the baseline information about the existing situations for the preparation of discharge documents they perceived between 25 August and 5 September 2019. The checklist started to implement since from 6 September 2019. The same questionnaire was administered to nurses between 13 and 20 December 2019 to evaluate the discrepancies of situations after the checklist implementation. Medication incident related to discharge issues was compared before and after the implementation of the checklist.
Result & Outcome :
We compared and analysed a pre questionnaire (n=24) and post questionnaire (n=28) with a response rate of 72.3% and 84.8% respectively. Of them, 80% of participants were registered nurse. 23% have worked in this ward for 6 years.
After implementing the reminder, nurses found statistical and clinical significance in self-perception on frequency of the medication incident related to patient discharge (t=2.58, p=0.013), frequency of the appointment issues related to patient discharge (t=3,65, p=0.001), frequency of the patient or relative enquiries after patient discharge (t=3.73, p< 0.0001), and frequency of the communication issue related to patients' discharge and between nurses and clerical staff for patient discharge (t=2.87, p=0.006).
Nurses also found they could understand and prepare well for patient document when other colleagues who handed over discharge documents to them using the discharge reminder (X2= 18.9, df=2, p< 0.0001), and felt confident to complete patient discharge document without any missing (X2= 10.6, df=2, p< 0.014). As of 8 January 2020, there was only one incident related to medication during discharge but the involved nurse did not use the checklist.
