Implementation of a Standardized Approach to Improve the Pediatric Discharge Medication Process.


BACKGROUND AND OBJECTIVES:The pediatric inpatient discharge medication process is complicated, and caregivers have difficulty managing instructions. Authors of few studies evaluate systematic processes for ensuring quality in these care transitions. We aimed to improve caregiver medication management and understanding of discharge medications by standardizing the discharge medication process. METHODS:An interprofessional team at an urban, tertiary care children's hospital trialed interventions to improve caregiver medication management and understanding. These included mnemonics to aid in complete medication counseling, electronic medical record enhancements to standardize medication documentation and simplify dose rounding, and housestaff education. The primary outcome measure was the proportion of discharge medication-related failures in each 4-week period. Failure was defined as an incorrect response on ≥1 survey questions. Statistical process control was used to analyze improvement over time. Process measures related to medication documentation and dose rounding were compared by using the χ2 test and process control. RESULTS:Special cause variation occurred in the mean discharge medication-related failure rate, which decreased from 70.1% to 36.1% and was sustained. There were significantly more complete after-visit summaries (21.0% vs 85.1%; P < .001) and more patients with simplified dosing (75.2% vs 95.6%; P < .001) in the intervention period. Special cause variation also occurred for these measures. CONCLUSIONS:A systematic approach to standardizing the discharge medication process led to improved caregiver medication management and understanding after pediatric inpatient discharge. These changes could be adapted by other hospitals to enhance the quality of this care transition.






Philips K,Zhou R,Lee DS,Marrese C,Nazif J,Browne C,Sinnett M,Tuckman S,Modi A,Rinke ML




Has Abstract


2021-02-01 00:00:00












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    pub_type: 杂志文章


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    pub_type: 杂志文章,随机对照试验


    authors: Aluisio AR,Maroof Z,Chandramohan D,Bruce J,Mughal MZ,Bhutta Z,Walraven G,Masher MI,Ensink JH,Manaseki-Holland S

    更新日期:2013-10-01 00:00:00

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    更新日期:2006-06-01 00:00:00

  • Enterobacter aerogenes primary bacteremia in pediatric patients.

    abstract::Enterobacter aerogenes bacteremia associated with the infusion of contaminated admixed intravenous (IV) fluid occurred in seven patients in a pediatric hospital over a five-day period. Clinical illness was characterized by spiking fever in all patients. The temporal clustering of cases allowed for rapid recognition of...


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    authors: Edwards KE,Allen JR,Miller MJ,Yogev R,Hoffman PC,Klotz R,Marubio S,Burkholder E,Williams T,Davis AT

    更新日期:1978-09-01 00:00:00

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    abstract::Ifosfamide is widely used in the treatment of pediatric solid tumors. Its main adverse effects are various forms of renal tubular and glomerular damage. Many risk factors have been proposed to play a role in the development and severity of nephrotoxicity in children receiving ifosfamide, among which are 1) patient's a...


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    authors: Loebstein R,Koren G

    更新日期:1998-06-01 00:00:00

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    authors: Englund JA,Anderson EL,Reed GF,Decker MD,Edwards KM,Pichichero ME,Steinhoff MC,Rennels MB,Deforest A,Meade BD

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    authors: Arvola T,Laiho K,Torkkeli S,Mykkänen H,Salminen S,Maunula L,Isolauri E

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