No CrossRef data available.
Article contents
Audit of documentation of allergies in a psychiatric inpatient unit
Published online by Cambridge University Press: 13 June 2014
Abstract
Objectives: This audit aimed to: identify the level of allergy documentation in admission notes, case notes and medication charts in the Department of Psychiatry, Portlaoise; establish the degree of compliance to the gold standard guidelines; highlight areas requiring further improvement and make realistic recommendations to ensure better compliance with the stipulated guidelines on allergy documentation; and re-audit after six months.
Methods: Gold standard guidelines on allergy documentation were obtained from various sources. Audit was performed over three days during which data was collected from the allergy section of medication charts, current case notes and original admission notes in both acute and long-stay wards. Recommendations were made and some were adopted, changes to practice were implemented for six months; at which time re-audit was performed.
Results: The initial audit revealed that: the allergy section was completed in 25% of medication charts; only 12% of current case notes had any documentation of allergy status; an for the original admission notes, the allergy section was documented in 65% of notes. Based on these results, a formal initial assessment proforma with a designated allergy section was introduced and a renewed awareness of the importance of the documentation of allergy status was actively promoted amongst non consultant hospital doctors (NCHDs). Six months later, re-audit showed that: in the medication charts there was a significant improvement in the level of compliance with documentation of allergy status (allergy or NKDA) in the allergy section up from 25% to 58.1%; in the current case notes, there was only marginal improvement in the level of compliance on the front of case notes from 12-19.1%; and in the original admission notes, there was also considerable improvement in the level of compliance with documentation of allergy status up from 65% to 80.9%.
Conclusion: This audit improved the level of documentation of allergy sections in the relevant areas and therefore helped in preventing avoidable and potentially fatal allergic reactions. It will also help save money for the Health Service Executive by reducing compensation costs filed by patients.
- Type
- Audit
- Information
- Copyright
- Copyright © Cambridge University Press 2011
References
1. Allergy the unmet need. A blue print for better patient care. A report of the Royal College of Physicians working party on the provision of allergy services in the UK 2003.Google Scholar
2.Kay, AB. Overview of allergy and allergic diseases: with a view to the future. Br Med Bul 2000; 56(4): 843–64. doi:10.1258/0007142001903481+. PMID 11359624.CrossRefGoogle ScholarPubMed
3.Cantrill, JA, Cottrell, WN. Accuracy of drug allergy documentation. Am J Health—Syspharm 1997; 54: 1627–1629CrossRefGoogle ScholarPubMed
4.Stedman T, L. Medical Dictionary. 25th Ed. William and Wilkins: Baltimore, USA, 1990.Google Scholar
5.Department of Health. Building a safer NHS for patient, improving medication safety. London: The Department; 2004.Google Scholar
6.Department of Health and Social Services Northern Ireland. Use and control of Medicines. Guidelines for the safe handling, administration, storage and custody of medicinal products in the health and personal Social Services. 2004.Google Scholar
7.Mirakian, Ret al.British Society for Allergy and Clinical Immunology Guidelines for the management of drug allergy. 2008.Google Scholar
8.Lazarou, J, Pomeranz, BH, Corey, PN. Incidence of adverse drug reactions in hospitalised patients: a meta-analysis of prospective studies. JAMA 1998; 279: 1200–5.CrossRefGoogle ScholarPubMed
11.Freemantle, N. Does the UK National Health Service need a fourth hurdle pharmaceutical re-imbursement to encourage the more efficient prescribing of pharmaceutical products. Health Policy 1999; 46: 255–65.CrossRefGoogle Scholar
12. Mental Health Commission. Annual Report, Book 1, Appendix 6: Medication Prescriptions in Approved Centres. 2008: 85–88.Google Scholar
13. Prescription Writing. Compiled by Oisin OhAlmahain. Pharmacy Department, Midlands Regional Hospital Tullamore Co. Offaly, 2005.Google Scholar
14.Abuelroos, et al.Audit Report on the Documentation of allergies on Drug Charts and Case Notes. South Tipperary Mental Health Service, Ireland 2006.Google Scholar
15.Crimmin, et al. Audit on Drug Allergy Documentation and Compliance with New Requirements for Allergy Name Bands at University Hospital Lewisham, South London, UK, 2005.Google Scholar