Evidence map›Paper›PMID 25794699›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016

Medication reconciliation for patients undergoing spinal surgery.

Pamela Kantelhardt, Alf Giese, Sven R Kantelhardt

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

3 authors.

Pamela KantelhardtDepartment of Neurosurgery, University Medical Centre Mainz, Johannes-Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
Alf GieseDepartment of Neurosurgery, University Medical Centre Mainz, Johannes-Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany.
Sven R KantelhardtDepartment of Neurosurgery, University Medical Centre Mainz, Johannes-Gutenberg University, Langenbeckstr. 1, 55131, Mainz, Germany. sven.kantelhardt@unimedizin-mainz.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn recent years, a marked increase of spinal operations prompted a debate on quality issues. Besides obvious factors, such as the surgical technique, medication safety has been identified as one of the major risk factors for patients undergoing anesthesia and surgery. While the issue has already been addressed by hospital pharmacist and anesthesiologists, the prescription of correct medication remains within the surgeons' responsibility. We, therefore, investigated medication-related errors in spinal instrumentation patients and applied current medication reconciliation strategies.

methodsWe performed a data survey on all patients undergoing spinal instrumentation in 2011. Risk factors for medication safety were identified and prioritized. Specific counter-measures were introduced in 2012 and evaluated in 2013.

results147 patients were included in the 2011 and 162 in the 2013 survey. As top five risk factors we identified the preoperative stopping of medication, recording the medication history, prescription process of postoperative analgetics and anticoagulants and the medication list at discharge. Specific counter-measures included standardization of preparations, doses and the prescription process and improving access to this information (online and via a smartphone application). In elective patients, recording the medication histories was delegated to a hospital pharmacist and informative flyers and posters were used to integrate the patients themselves into the process. Counter-measures directed against the first four risk factors resulted in a significant reduction of medication errors. The last risk factor was targeted by instructing the responsible staff only, which proved to be a rather ineffective measure.

conclusionsMedication safety could be significantly improved by implementation of counter-measures specific to the identified risk factors.

Indexed as

Neurosurgical ProceduresQuality ImprovementAdultAgedAged, 80 and overAnalgesicsAnticoagulantsChecklistFemaleHumansMaleMedication ErrorsMedication ReconciliationMiddle AgedMobile ApplicationsPatient DischargeAnalgesicsAnticoagulantsHospital pharmacistMedication reconciliationMedication safetySpinal instrumentation

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.