Abstract | OBJECTIVES: Evaluate potassium and phosphorus repletion in hospitalized patients. Assess the potential role for use of various methods, including healthcare information technology, to improve prescribing and patient safety. RESEARCH DESIGN AND METHODS: Inpatient medication profiles were screened to identify orders for potassium and phosphorus replacement products. Electronic laboratory and medical records were used to evaluate efficacy and safety. Eligibility for oral therapy was defined by the presence of other scheduled oral medications on the medication profile. Appropriateness of prescribing was based on adherence to the hospital guidelines for repletion. RESULTS: Overall, 134 orders for potassium in 92 patients and 36 orders for phosphorus in 27 patients were evaluated over a 3-week data collection period. Intravenous (IV) potassium was prescribed in 73% of replacement episodes (46% as single doses and 54% within large volume IV fluids), with 85% for normokalemia or mild-to-moderate cases of hypokalemia. Phosphorus orders involved single doses of IV potassium phosphate (mean 13.1 mmol) in 75% of cases. Approximately 85% of doses were for mild or moderate hypophosphatemia. Eligibility for oral therapy was evident in 74% of normokalemic or mild hypokalemic cases receiving IV potassium products and in 33% of cases receiving IV phosphorus replacement. Six cases of mild hyperkalemia were observed. No hyperphosphatemia was documented. Study limitations include use of a retrospective design, inability to discern whether some electrolyte doses were given with a preventative intent, potential overestimation of the number of patients eligible for oral repletion, and lack of data on the accessibility of the laboratory serum concentrations or the awareness of serum values to the prescribers. CONCLUSIONS:
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Authors | Brian A Hemstreet, Nancy Stolpman, David B Badesch, Sondra K May, Marianne McCollum |
Journal | Current medical research and opinion
(Curr Med Res Opin)
Vol. 22
Issue 12
Pg. 2449-55
(Dec 2006)
ISSN: 1473-4877 [Electronic] England |
PMID | 17257459
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Delivery of Health Care
- Drug Prescriptions
- Female
- Hospitalization
- Humans
- Hypokalemia
(drug therapy)
- Hypophosphatemia
(drug therapy)
- Infusions, Intravenous
- Male
- Medical Informatics
- Middle Aged
- Phosphorus
(administration & dosage, adverse effects)
- Potassium
(administration & dosage, adverse effects)
- Practice Guidelines as Topic
- Retrospective Studies
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