Medication Discrepancies at Pediatric Hospital Discharge

Abstract

BACKGROUND: The pediatric hospital discharge process presents significant challenges, and medication discrepancies remain an unsolved problem. The purpose of this study was to determine the discrepancy rates at the time of discharge when multiple sources of medication documentation exist, and to characterize the medication discrepancies into error type, medication category, and discharge summary authorship. METHODS: A prospective study was performed on pediatric patients admitted to a general inpatient floor for >24 hours. After discharge, medication lists were obtained from the patients’ parent/guardian, discharge summary, and Patient Summary List, a medication list that is part of the electronic medical record. These 3 medication lists were then compared with the pharmacy record to identify discrepancies, defined as any difference in medication name, dose, route, or frequency. Medication discrepancies were analyzed in terms of error type (dosage or addition/omission), category of medication, and final signers of the discharge summary. RESULTS: Sixty-nine patient charts were analyzed, and 8% of medications contained a documentation discrepancy between sources. Overall, 26% (18 of 69) of the charts contained ≥1 discrepant medication; the Patient Summary List had the highest rate of discrepancy at 29%. Allergy (27%) and seizure medications (25%) were the categories with the highest rates of discrepancy. Addition/omission errors were much more common than dosage errors. CONCLUSIONS: Medication discrepancies exist in inpatient documentation at the time of pediatric hospital discharge when multiple sources of documentation exist.