Effect of Instructions Set by the Dementia and Delirium Support Team on the Management of Insomnia and Restlessness When Changing Electronic Medical Record Vendors

Toshikazu ICHIE; Noriko KUBOTA; Chise HONDA; Megumi YOKODE; Mayu MINAMIKAWA; Mika OSAKI; Tsubasa SASAKI; Michiyo HIROUMI; Takeshi MIURA; Zen NONOGAKI

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Effect of Instructions Set by the Dementia and Delirium Support Team on the Management of Insomnia and Restlessness When Changing Electronic Medical Record Vendors

VernacularTitle:認知症せん妄サポートチームによる電子カルテのベンダー変更時の不眠時・不穏時の指示見直しとその影響について
Author: Toshikazu ICHIE ¹ ; Noriko KUBOTA ² ; Chise HONDA ¹ ; Megumi YOKODE ¹ ; Mayu MINAMIKAWA ³ ; Mika OSAKI ³ ; Tsubasa SASAKI ³ ; Michiyo HIROUMI ⁴ ; Takeshi MIURA ³ ; Zen NONOGAKI ¹
Author Information

1. Depts. of Pharmacy, Kainan Hospital
2. Laboratory of Community Pharmaceutical Practice and Science, Gifu Pharmaceutical University
3. Depts. of Nursing, Kainan Hospital
4. Depts. of Psychiatry, Kainan Hospital
From:Journal of the Japanese Association of Rural Medicine 2024;73(4):347-355
CountryJapan
Language:Japanese
Abstract: Use of benzodiazepine (BZD) receptor agonists for delirious or elderly patients has occasionally been found as a result of inappropriate instructions for insomnia or restlessness, according to research of the dementia and delirium support team (DDST), which manages instructions on admission and during hospital rounds. We believe that one reason for this is the lack of hospital guidelines for managing insomnia and restlessness. When changing electronic medical record vendors, we took the opportunity to establish proper drug usage instructions. The percentage of available instructions for insomnia and restlessness at the time of admission and the prescribed medications were surveyed and compared before and after the vendor change. The prescription rate for insomnia was 88.6% (1,779/2,007) before and 91.9% (1,902/2,069) after the change, showing a significant increase. The prescription rate of benzodiazepine receptor agonist use was 47.7% (848/1,779) before and 41.6% (792/1,902) after the change, showing a significant decrease. The prescription rate for restlessness was 71.2% (1,429/2,007) before and 85.6% (1,771/2,069) after the change, showing a significant increase. The recommended drug usage instructions affected prescriptions for insomnia and restlessness at admission and prescriptions of BZD receptor agonist usage at admission. Our findings seem to suggest that setting drug usage instructions for insomnia and restlessness when changing the electronic medical record vendor will be useful for promoting proper medication use.