Admission Medication Reconciliation Discrepancies in Trauma Patients: Consistent Nursing Care May Not Be the Answer.

Inadvertent medication reconciliation discrepancies are common among trauma patient populations. We conducted a prospective study at a level 1 trauma center to assess incidence of inadvertent medication reconciliation discrepancies following decreased reliance on short-term nursing staff. Patients and independent sources were interviewed for home medication lists and compared to admission medication reconciliation (AMR) lists. Of the 108 patients included, 37 patients (34%) never received an AMR. Of the 71 patients that had a completed AMR, 42 patients (59%) had one or more errors, with total 154 errors across all patients, for a rate of 3.7 per patient with any discrepancy. Patients taking ≥ 5 medications were significantly more likely to have an incomplete or inaccurate AMR than those taking <5 medications (89% vs 41%, P < .0001). Decreased reliance on short-term nursing staff did not decrease inadvertent admission medication reconciliation discrepancies. Additional interventions to decrease risk of medication administration errors are needed.

Incidence and Severity of Medication Reconciliation Discrepancies in Trauma Patients.

Trauma patients are especially vulnerable to inadvertent medication reconciliation discrepancies. We conducted a prospective study to evaluate the USA Health University Hospital's incidence and type of inadvertent medication reconciliation discrepancies among trauma patients. Patients were interviewed for accuracy of their admission medication reconciliation (AMR). Eighty-nine patients were included in this study. Twenty-six patients (29%) never received an AMR. There were 107 inadvertent medication reconciliation errors identified from 30 separate patients (48%), for a rate of 3.6 errors per patient with any error. There was a significant difference in the frequency of inadvertent medication reconciliation discrepancies for patients with >5 medication compared to those with fewer (P = .00029). In conclusion, trauma centers must be adequately staffed to provide timely, accurate, and available medication lists so that patients can be appropriately cared for.

Examining Race-Related Error in Two-Compartment Models of Body Composition Assessment: A Systematic Review and Meta-Analysis.

BACKGROUND: The Brozek and Siri formulas estimate relative adiposity (%Fat) from total body density (Db) using a 2-compartment (2C) model. Racial/ethnic differences in Db have been reported, along with subsequent errors in estimated %Fat. OBJECTIVE: The primary aim of this systematic review and meta-analysis was to examine potential race/ethnic differences in the accuracy of the Brozek and Siri 2C formulas using aggregate-level data. METHODS: Peer-reviewed studies available in English that provided 2C and 4C estimates of %Fat were located using searches of the PubMed (n = 150), Scopus (n = 170), and Web of Science (n = 138) online electronic databases. Random-effects models were used to determine potential differences between racial groups using a mean ES and 95% confidence intervals. RESULTS: The cumulative results from 78 effects indicate that the relative accuracy of the Brozek equation did not vary between racial groups (between group p = 0.053). In contrast, the Siri equation slightly underestimated %Fat for Asian adults (ESWMD = -1.40%, 95%CI -2.33% to -0.46%; p = 0.004) and Black adults (ESWMD = -1.10%, 95%CI -2.11% to -0.08%; p = 0.034), with no significant differences observed in Hispanic adults (ESWMD = 0.64%, 95%CI -1.02% to 2.31%; p = 0.448) and White adults (ESWMD = 0.08%, 95%CI -0.42% to 0.57%; p = 0.766) (between group p = 0.019). CONCLUSION: Small, but statistically significant, error was found between racial groups when estimating %Fat using the 2C Siri equation when compared to 4C models. However, the observed error due to race/ethnicity appears to be of little clinical or practical significance when using either equation.