title: Prevalence and Clinical Significance of Discrepancies within Three Computerized Pre-Admission Medication Lists.
abstract: Inaccurate records of pre-admission medication exposure have been identified as a major source of medication error. Authors collected records of patients' pre-admission medications: 1) the most recent outpatient medication list ("EMR"), 2) the medication list recorded by admitting providers ("H&P"), and 3) a list generated by a medication reconciliation process conducted by nursing staff ("PAML"). Forty-eight sets of pre-admission records composed of 1087 medication entries were compared to a reference standard generated by trained study staff conducting an independent interview. Sensitivity was greatest for PAML (85%), compared to EMR (76%) and H&P (76%) sources. However, positive predictive value was greatest for the H&P source at 96% vs 88% and 91% for PAML and EMR sources respectively. Potentially harmful medication discrepancies were found within all lists. The authors concluded no single list was sufficiently accurate to avoid serious medication errors.
authors.affiliation: Department of Biomedical Informatics, Vanderbilt University, Nashville, TN.
authors.forename: Josh F
authors.initials: JF
authors.lastname: Peterson
authors.forename: Yaping
authors.initials: Y
authors.lastname: Shi
authors.forename: Josh C
authors.initials: JC
authors.lastname: Denny
authors.forename: Michael E
authors.initials: ME
authors.lastname: Matheny
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Schildcrout
authors.forename: Lemuel R
authors.initials: LR
authors.lastname: Waitman
authors.forename: Randolph A
authors.initials: RA
authors.lastname: Miller
mesh_terms: D006760:Hospitalization; D006801:Humans; D008508:Medication Errors; D059065:Medication Reconciliation; D010343:Patient Admission; D015995:Prevalence