Medication safety and improving communication at care transitions are an
international priority. There is vast evidence on the scale of error associated
with medicines reconciliation and some evidence of successful interventions to
improve reconciliation. However, there is insufficient evidence on the factors
that contribute towards medication error at transitions, or the roles of those
involved. This thesis examined current UK medicines reconciliation practice
within primary and secondary care, and the role of HCPs and patients. Using a
mixed-method, multi-centre design, the type and severity of discrepancies at
admission to hospital were established and staff undertaking medicines
reconciliation across secondary and primary care were observed, using
evidence-informed framework, based on a narrative literature review.
The overall processes used to reconcile medicines were similar; however, there
was considerable inter and intra-organisational variation within primary and
secondary care practice. Patients were not routinely involved in discussions
about their medication, despite their capacity to do so. Various human factors
in reconciliation-related errors were apparent; predominantly inadequate
communication, individual factors e.g. variation in approach by HCP, and
patient factors e.g. lack of capacity. Areas of good practice which could reduce
medicines reconciliation-related errors/discrepancies were identified. There is a
need for increased consistency and standardisation of medicines reconciliationrelated
policy, procedures and documentation, alongside communication
optimisation. This could be achieved through a standardised definition and
taxonomy of error, the development of a medicines reconciliation quality
assessment framework, increased undergraduate and post-graduate education,
improved patient engagement, better utilisation of information technology and
improved safety culture.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/7288 |
| Date | January 2014 |
| Creators | Urban, Rachel L. |
| Contributors | Armitage, Gerry R., Blenkinsopp, Alison, Marshall, Kay M., Morgan, Julie D. |
| Publisher | University of Bradford, School of Pharmacy |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Thesis, doctoral, PhD |
| Rights | <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>. |
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