evidence and practice
Exploring medicines reconciliation in the emergency assessment unit: staff perceptions and actual waiting times
Charlie Ellison Charge Nurse, NHS Blood and Transplant Service, Newcastle upon Tyne, England
Katie Hackett Associate Professor, Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, England and occupational therapist, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England
Dennis Lendrem Research Associate, National Institute for Health Research, Newcastle Biomedical Research Centre, Newcastle upon Tyne, England
Clare Abley Nurse Consultant, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, England and honorary senior clinical lecturer, Population Health Sciences Institute, Newcastle University, England
• To recognise why timely medicines reconciliation is important in the emergency assessment unit (EAU)
• To understand the barriers to timely medicines reconciliation in the EAU
• To identify potential methods of improving medicines reconciliation in the EAU
Background Medicines reconciliation is the process of creating and maintaining the most accurate list possible of all medicines a patient is taking. If medicines reconciliation cannot be completed in a timely manner in hospital emergency assessment units (EAUs), delays in treatment can occur, potentially leading to deterioration of long-term and acute conditions, patient distress and complaints.
Aim To obtain the perspectives of staff working on an EAU regarding the time patients wait for their medicines to be prescribed, including their awareness of practice and protocols. To determine the time from admission to the EAU until medicines reconciliation, and to identify if there was any time difference in medicines reconciliation according to the day of admission.
Method This was a service evaluation in which staff working in one EAU in a teaching hospital in the north east of England were asked to complete a survey in December 2017. The staff survey aimed to ascertain: whether staff were aware of any guidance relating to medicines reconciliation times; how long they thought the average waiting time was for medicines reconciliation; and if they thought there were implications for patients or staff as a result of time spent waiting for medicines reconciliation. In addition, an audit was performed analysing medicines reconciliation times for all patients admitted to the EAU during the month of December 2017.
Results A total of 30 staff members responded to the survey. While 40% (n=12) of respondents believed that the EAU had an efficient system in place for timely medicines reconciliation, 90% (n=27) believed the unit could still improve. Almost half the respondents (47%, n=14) perceived a delay in medicines reconciliation could result in exacerbation of patients’ physical conditions. The clinical audit identified considerable variation in medicines reconciliation times, ranging from seven minutes to almost 24 hours. However, most medicines (82%) were reconciled within six hours.
Conclusion This service evaluation found that the median time after arrival in the EAU until completion of medicines reconciliation was two hours 48 minutes. However, almost one fifth of patients had to wait for more than six hours, and in one instance almost 24 hours. One potential solution could be increasing the involvement of hospital pharmacists or pharmacy technicians in medicines reconciliation.
Emergency Nurse. doi: 10.7748/en.2020.e1988Peer review
This article has been subject to external double-blind peer review and has been checked for plagiarism using automated softwareCorrespondence
Ellison C, Hackett K, Lendrem D et al (2020) Exploring medicines reconciliation in the emergency assessment unit: staff perceptions and actual waiting times. Emergency Nurse. doi: 10.7748/en.2020.e1988
Acknowledgements One of the authors, Charlie Ellison, was awarded a competitive Newcastle upon Tyne NHS Foundation Trust research and development internship which was funded by National Institute for Health Research (NIHR) research capability funding
Accepted 16 January 2020
Published online: 12 May 2020
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