title: Recording of drug allergies: are we doing enough?
abstract: OBJECTIVE
  To assess the implementation of local and national guidelines concerning documentation of drug/clinical hypersensitivities.
  
  
  METHODS
  Audit with retrospective and prospective components used to assess the process of drug hypersensitivity documentation.
  
  
  METHODS
  Fifty surgical inpatients' notes were retrospectively analysed followed by 63 patients prospectively.
  
  
  METHODS
  West London teaching hospital.
  
  
  METHODS
  Drug hypersensitivity status correctly indicated on clinical notes, drug 'Kardex' charts, and anaesthetic records; these three documents were to concur. Hypersensitivities qualified according to symptoms experienced.
  
  
  CONCLUSIONS
  Standardization of preoperative clinical notes and multidisciplinary responsibility for records between doctor, nurse and pharmacist.
  
  
  RESULTS
  Hypersensitivity documentation in clinical notes improved by 7% after the introduction of a formalized history sheet for preoperative clinics. These were based upon the anaesthetic charts, which had demonstrated 100% documentation previously. Considerable improvements (70.8%) in the clarification of adverse reaction symptoms post recommendation were shown; this was also attributed to the new history sheet. Concurrence improved by 2%.
  
  
  CONCLUSIONS
  The original study revealed areas for improvement and provided part of the solution--a more standardized preoperative assessment tool. Multidisciplinary cooperation in addition to formalizing the assessment process has led to a more efficient and safer service for patient and medicolegally for health care professionals.
  
  
  CONCLUSIONS
  (1) Standardized forms, for the recording of clinical information preoperatively, ensure relevant guidelines are implemented in practice. (2) Multidisciplinary teams provide a vital safety net for their patients and colleagues.
authors.affiliation: Department of Surgical Oncology and Technology, Imperial College, St Mary's Hospital, London, UK. anna.radford@imperial.ac.uk
authors.forename: Anna
authors.initials: A
authors.lastname: Radford
authors.forename: Shabnam
authors.initials: S
authors.lastname: Undre
authors.forename: Nawar A
authors.initials: NA
authors.lastname: Alkhamesi
authors.forename: Sir Ara W
authors.initials: SA
authors.lastname: Darzi
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000592:standards*; D004342:Drug Hypersensitivity; D019983:Guideline Adherence; D006801:Humans; D008499:Medical Records / Q000592:standards*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012189:Retrospective Studies