A study Headed by Austin Health in Melbourne, he found that about one-fifth of the medicines delivered to Melbourne’s public care, surgical wards, and emergency departments (EDs) were not given to patients.
The studyIn 2019, led by Austin Health’s Director of Emergency Medicine Research, David Taylor concluded that approximately 19.2% of medical and surgical wards and ED medications in four public hospitals in Melbourne were not given to patients.
“Public hospitals don’t consider significant amounts of drugs,” Taylor et al. Wrote after examining drug supply and administration data for 20 frequently used drugs.
The four hospitals investigated in this study were Austin, Box Hill, Footscray, and Frankston Hospitals in Melbourne, Victoria, with an estimated total cost of missing medicines of approximately $ 27,000. Approximately 0.02 percent of the 2019 dosing budget of $ 124,979,795 for the wards included in the four hospitals.
The drugs they analyzed were divided into four broad categories: antibiotics, gastrointestinal drugs, benzodiazepines, antidepressants, and analgesics.
Among the drugs not considered, oral drugs such as antibiotics and gastrointestinal drugs were the highest, and the disagreement of drugs useful for self-treatment was higher.
About 86.8 percent of phenoxymethylpenicillin in 250 mg capsules, a type of oral antibiotic, was not given.
It was also deficient in 53.3 percent of the 4 mg tablets of ondansetron used as a gastrointestinal drug.
The authors reasoned that the major disagreement in oral medications could be due to staff taking the medication for self-medication. In contrast, parenteral treatment had a lower disagreement rate, so this may be due to waste.
Overall, disagreements were highest in the emergency department, at 32.3%, compared to 16.0% and 12.1% in the medical and surgical wards, respectively.
The authors were pleased to find that the rate of discrepancies in controlled medications that could lead to addiction was low. However, individual hospitals have high proportions of oxycodone, opioids, and temazepam, which are commonly used to treat insomnia and may require further research.
The reason for the discrepancy has not been investigated, but the authors suggested that “drug discrepancies are partially explained by theft, usually for self-treatment, especially in the case of oral treatment.”
These suggestions are 2019 A study led by Bairnsdale Community Health Services, Victoria’s Community Health Services.
Taylor and his colleagues reasoned that the high disagreement rate for ED could be due to the fact that drugs are often transferred from ED to other wards and services. Transfers can bypass supply and management systems, especially during non-normal working hours.
“Patients discharged to their home hospital may be given parenteral medications to ensure continuity of treatment before a reliable source is available, and doctors will replace the prescription with discharged patients. May offer a starter pack or a complete dosing course, “the author writes.
“A relatively busy environment and an increase in the number of ED staff can also cause discrepancies.”
Other possible explanations for the discrepancy include failure to administer medication and document oral instructions, the medication recording system may also be temporarily down, and there are administrative errors. Changes in drug supply levels, inventory recalls, spills, waste, and drug expiration are also possible reasons for discrepancies.
However, Taylor and his co-authors concluded that a discrepancy rate of about 20% was “clinically important” and recommended that intervention be performed.
“We encourage you to verify the integrity of your electronic drug supply and control data and compare your electronic and manual audit data,” the authors say.
“You can consider the camera in the dosing room and consider the steps to avoid diversion and balance supply and use.”
The journal is dedicated to staff education, rigorous management procedures and audits, improved tracking of medications transferred to wards, patients or other services, and the development of appropriate interventions, including when they are not used. For some reason I concluded that I needed to investigate the reason for the discrepancy.