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Research paper|Articles in Press

Implementation of a pragmatic emergency department patients’ own medications (POM) procedure to improve medication safety: An interrupted time series

  • Simone E. Taylor
    Correspondence
    Correspondence to: Pharmacy Department, Austin Health, Studley Road, Heidelberg, Victoria 3084, Australia.
    Affiliations
    Pharmacy Department, Austin Health, Studley Road, Heidelberg, Victoria, Australia

    Emergency Department, Austin Health, Studley Road, Heidelberg, Victoria, Australia
    Search for articles by this author
  • Emily Joules
    Affiliations
    Pharmacy Department, Austin Health, Studley Road, Heidelberg, Victoria, Australia

    Emergency Department, Austin Health, Studley Road, Heidelberg, Victoria, Australia

    Patient Safety and Clinical Excellence, Austin Health, Studley Road, Heidelberg, Victoria, Australia
    Search for articles by this author
  • Andrew Harding
    Affiliations
    Pharmacy Department, Austin Health, Studley Road, Heidelberg, Victoria, Australia

    Emergency Department, Austin Health, Studley Road, Heidelberg, Victoria, Australia
    Search for articles by this author
Published:March 01, 2023DOI:https://doi.org/10.1016/j.auec.2023.02.004
Implementation of a pragmatic emergency department patients’ own medications (POM) procedure to improve medication safety: An interrupted time series
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      Abstract

      Background

      Patients’ Own Medications (POMs) are useful to inform clinical decision-making, best possible medication history documentation, and ensure timely medication administration. A procedure was developed for managing POMs specifically in the emergency department (ED) and short stay unit. This study evaluated the impact of this procedure on process and patient safety outcomes.

      Methods

      An interrupted time-series was undertaken in a metropolitan ED/short stay unit between November 2017 and September 2021. Pre-implementation and during each of four post-implementation time-periods, data were collected at unannounced times on approximately 100 patients taking medications prior to presentation. Endpoints included proportion of patients with POMs stored in green POMs bags, in standardised locations, and proportion who self-medicated without nurses knowing.

      Results

      Following procedure implementation, POMs were stored in standardised locations for 45.9 % of patients. Proportion of patients with POMs stored in green bags increased from 6.9 % to 48.2 % (difference 41.3 %, p < 0.001). Patient self-administration without nurses’ knowledge declined from 10.3 % to 2.3 % (difference 8.0 %, p = 0.015). POMs were infrequently left in ED/short stay unit after discharge.

      Conclusions

      The procedure has standardised POMs storage, but room for further improvement remains. Although POMs were not locked away and were readily available to clinicians, patient self-medication without nurses’ knowledge declined.

      Keywords

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      Article info

      Publication history

      Published online: March 01, 2023
      Accepted: February 17, 2023
      Received in revised form: February 14, 2023
      Received: September 30, 2022

      Publication stage

      In Press Corrected Proof

      Identification

      DOI: https://doi.org/10.1016/j.auec.2023.02.004

      Copyright

      © 2023 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.

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