Abstracts

Rationale: There is no formal process for medication reconciliation prior to epilepsy surgery at Texas Children's Hospital. This has led to medication errors during admission due to lack of ensuring an accurate medication list and continuing medications as they appeared on patients medication list. In addition, delays in therapy occurred due to medications being non-formulary, and increased calls to the clinic to inquire what to do the day of surgery. The primary objective of this quality improvement (QI) project was to evaluate the number and type of medication errors caught by implementing medication reconciliation prior to arrival at the hospital. The secondary objective is to evaluate the number and type of medication errors upon discharge, where no medication reconciliation is performed Methods: In June 2015, the Clinical Pharmacy Specialist and Clinical Nurse Coordinator for the Comprehensive Epilepsy Program created a template and process for a pre-surgical medication review, by which the clinical nurse coordinator calls the patient a week prior to surgery for medication reconciliation. Inclusion criteria for QI project: All patients undergoing epilepsy surgery Exclusion criteria for QI project: No pre-surgical assessment performed A prospective evaluation was performed following the nurse phone call to characterize what medication errors were corrected and therefore potentially prevented during admission. A second retrospective assessment was completed following discharge to evaluate if medication errors occurred, as no medication reconciliation is in place during this transition. Clinical pharmacy specialist reviewed all medication errors and classified each error according to its potential severity (clinically insignificant, significant, serious, life threatening). Severity definitions were adapted from previously published studies. Results: Data was collected between 6/30/2015 ?" 4/20/2016 (from first call of protocol until present). 47 patients were queried, 9 excluded; study population of 38 patients. Half of the patients were male with a median age of 8.6 years, on a median of 2 antiepileptic drugs (AEDs). During the prospective evaluation, 17 patients (45%) had some form of error in their med list. These ranged from clinically insignificant (adjusting dose of non-AED) to serious (adding AED to med list). Upon discharge, 5 patients (13%) had an error in their medication prescription ranging from significant to serious in severity. Complete list of errors will be presented. Conclusions: The new process is able to prevent up to 45% of medication errors in patients undergoing epilepsy surgery during hospital admission. However, a percentage of errors will continue to occur upon discharge until a process of medication reconciliation is in place. Funding: N/A