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Kidney Week

Abstract: SA-PO014

Association of Nephrology Inpatient Service Size on Medication Safety Recommendations

Session Information

  • Educational Research
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 800 Educational Research

Authors

  • Chen, Huiwen, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • Ahmad, Syeda B., University of Pittsburgh, Pittsburgh, Pennsylvania, United States
  • Johnston, James R., University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States
  • DeSilva, Ranil N., University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
Background

Providing quality and safety care are the highest goals for most medical institutions. Quality care is difficult to define but has been linked with adequate staff to patient rato, timely care, and medical error reduction. Emergency department and intensive care units have studies that have identified safe and optimal nurse-to-patient ratios and physician-to-patient ratios respectively. The nephrology field lacks data in this area.

Methods

Retrospective chart review of general nephrology consults placed from Jan 1st 2018 to Dec 31st 2018. Daily service size and physician work schedules were reviewed with distribution analyzed. High patient census defined as greater than 40 ( top 10%), low patient census defied as less than 26 ( bottom 10%). Four types of renal related medications were assessed: electrolyte related, antibiotics related, nephrotoxic agents and central nervous system related. Medication errors were exressed as percentage and coordinated with daily service size. Clinical adverse outcomes associated with medication erros were also reviewed.

Results

11.2% of the medication errors were experienced by our patients during the high census days vs 19.4% during the low census days. P= 0.225
Potential confounders include: higher census days were more prevalent in the winter months, and more experienced fellows and house staff worked during the winter months. Also there was low awareness of nephrologists responsibility to commend of renal dosed medication as standard consult recommendations amongst nephrology fellows.

Conclusion

The number of overloaded medication errors did not differ based on renal service size. However, patients expereinced greater than 10% of the medication errors in 2018. A pharmacist might be needed in the nephrology consult service to reduce the errors of renally excreted medication experienced by our patients. Awareness of nephrologists' role in medication safety recommendation shall be heightened by nephrology training programs.