Hospital Pharmacist
2008;15:67-68
February 2008

Medicine left at discharge — an audit of two orthopaedic wards

By Natalie Mann

Medicines dispensed for a patient are often found on the ward after the patient has been discharged. This article describes an audit undertaken by a pharmacy technician to investigate why this happens and the estimated cost implications

Focus on technicians series

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SUMMARY

Medicines can become separated from the patient for whom they have been dispensed for a number of reasons. At Southampton General Hospital (SGH) it was noticed that despite discharge prescriptions being dispensed in advance, a significant number of medicines were being left on the wards after the patient had been discharged or transferred.

At SGH, the patient’s own drugs (POD) technician is responsible for sorting out these medicines, which are either discarded or returned to pharmacy.

Aims

The aim of this audit was to establish the quantity of medicines left on two orthopaedic wards following patients’ discharge or transfer, and to determine the reasons for this and the estimated cost to the trust.

Method

The audit was carried out on a trauma ward (F3) and an elective surgery ward (F1) over a three week period in January 2007. Before starting data collection, the “return” boxes on the wards were emptied and the drug trolleys and cupboards were checked for any PODs. Copies of the discharge prescriptions for all patients on wards F1 and F3 were kept during the data collection period.

Each day, the treatment rooms and return boxes were checked for any medicines that had been left behind. For each medicine found, the reason for it being left was investigated. This was done by checking the ward planning books or asking the nurses or ward clerk.

The reasons were each given a code, based on recognised reasons for medicines being left on the wards. These reasons are outlined in Panel 1 (right).

The ward pharmacist was informed of any important medicine(s) that had been left behind.

Estimating costs For medicines that had been dispensed by SGH, the cost of the medicines was calculated by multiplying the cost of a single tablet or item by the quantity left behind.

The estimated cost to the hospital of dispensing and returning the items that were left behind was also calculated. It was estimated that it takes five minutes to clinically screen the prescription for an item, five minutes to dispense it, five minutes to check it and two minutes for the POD technician to return it into the computerised stock system.

An estimate of the cost of the total time spent carrying out these tasks during the audit period was calculated based on the basic pay for the staff involved. For the purpose of the audit it was taken that a band six pharmacist would screen the item, and band 5 technicians would dispense, check and return the items.