Vol. 43 No. 2 February 2012 449Poster Abstracts

from participating providers, and case discus-sion and recommendations provided by theUNM IDT.

Result. Feasibility was demonstrated. Providersatisfaction was high. Self-efficacy improved.Sense of isolation decreased.

Conclusion. The Palliative Medicine ECHOclinic at the University of New Mexico has dem-onstrated a new model for training rural primarycare providers in care for patients at end of life.

Implications for Research, Policy, or Practice.This program can serve as a model for trainingof mid-career clinicians dealing with patients atend of life, and expansion of this model to otherregions in the country will be discussed.

Impact of an Electronic Medication ErrorReporting System in a Hospice Organization(749)Mina Kim, Pharm.D, University of WashingtonMedical Center, Fullerton, CA. Mary LynnMcPherson, Pharm.D BCPS, University of Mary-land School of Pharmacy, Baltimore MD. SheilaWeiss Smith, PhD, University of MarylandSchool of Pharmacy, Baltimore MD. ElizabethKopochis, RN MS, Seasons Healthcare Manage-ment, Rosemont, IL.

Objectives1. Observe the impact of the implementation of

an electronic-based reporting system on theoccurrence of medication error reports inthe hospice setting.

2. Recognize barriers to medication error re-porting in hospice and attitudes of hospiceclinical staff members regarding medicationerror reporting.

Background. Reporting medication errors areimportant as they allow weak points in the healthcare system to be identified andhelp guide systemchanges needed to improve safety for patients.Numerous studies have shown the positive impacton the volume of reports through the implemen-tation of electronic reporting systems.

Research Objectives. The purpose of this studyis to examine the impact of the implementationof an electronic-based reporting system on theoccurrence of medication error reports in thehospice setting.

Method. An electronic medication error report-ing system was developed and an inservice wasprovided to participants. Medication error

reports were collected and analyzed comparingtwo specific time-periods. The pre-interventiondata was collected for a two year period andconsisted of medication error reports from thehospicea�s paper-based system. The post-inter-vention data was collected for a 120 day periodand consisted of reports from the newly elec-tronic-based system.

Result. Prior to the implementation of the elec-tronic medication error reporting system, therewas an average of 0.9 error reports submittedper month over a two year period. The averagenumber of error reports with the new electronicsystem increased to 8 reports per 30 day period.Most of the medication errors reported were ad-ministration errors which were consistent whencomparing pre- and post-intervention reports.A majority of medication errors resulted in noharm to the patients but almost a third of pa-tients did experience some form of harm.

Conclusion. The implementation of an elec-tronic medication error reporting system led toan increase in medication error reporting ratesin a hospice organization.

Implications for Research, Policy, or Practice.The hospice setting has little to no research con-ducted on medication errors. This study looks toshow the positive impact of an electronic report-ing system on medication error reporting inhospice.

Medication Error Reporting Practices inHospice (750)Mina Kim, Pharm.D, University of WashingtonMedical Center, Fullerton, CA. Mary LynnMcPherson, Pharm.D BCPS, University of Mary-land School of Pharmacy, Baltimore MD.

Objectives1. Better understand the current status ofmedica-

tion error reporting in hospice organizations.2. Become aware of barriers to medication error

reporting in hospice.3. Recognize attitudes of hospice clinical staff

members regarding medication errorreporting.

Background. Hospice organizations have little tono published data on medication errors. Due tothe limited data on this topic, the goal of this re-search was to gather information and establishthe current status of medication error reportingin hospice organizations.

450 Vol. 43 No. 2 February 2012Poster Abstracts

Research Objective. The purpose of this studywas to conduct a national survey to collect dataon medication error reporting practices inhospice.

Method. A survey was developed assessing cur-rent medication error reporting practices inhospice. The survey included questions regard-ing hospice demographics, medication error re-ports and the reporting process. Additionalquestions were asked assessing the attitudes ofemployees regarding medication error report-ing. In conjunction with The National Hospiceand Palliative Care Organization (NHPCO), ap-proximately 2500 hospice organizations were in-vited to participate in the survey administeredthrough the online survey tool: SurveyMonkey.Participation was voluntary and surveys weresubmitted anonymously.

Result. 269 hospice organizations completed thesurvey. A majority of hospices have been in prac-tice for greater than 20 years and almost all re-ported having a medication error reportingprogram. In addition, 81% of hospices have a pa-per-based medication error reporting systemwhile the rest use an electronic-based system. Amajority of hospices (47%) had a medication er-ror occurrence rate of 0.1e1.0% and 45 hospices(18%) reported having a 0% error rate in admit-ted patients. Administration errors were themost commonly pinpointed area in which a med-ication error was likely to occur followed by tran-scribing and dispensing.

Conclusion. There is exceptionally low rate ofmedication error reporting and lack of informa-tion regarding reporting practices in the hospicepopulation.

Implications for Research, Policy, or Practice.Results from this survey hope to bring moreawareness on current practices in hospiceand encourage more attention by hospice or-ganizations to this fundamental area in healthcare.

Anticipatory Grief Among FamilyCaregivers of Patients With AdvancedCancer, Congestive Heart Failure, andChronic Obstructive Pulmonary Disease(751)Jessica Sautter, PhD, Duke University MedicalCenter, Durham, NC. Karen Steinhauser, PhD,Duke & VA Medical Center, Durham, NC. James

Tulsky, MD, Duke University/Durham VA Medi-cal Center, Durham, NC.

Overall Objectives1. Identify risk factors for caregiver anticipatory

grief.2. Become aware of differences in caregiver re-

actions to advanced chronic illness.

Background. Anticipatory grief (AG) is associ-ated with depression and anxiety and may haveimplications for post-death bereavement. MostAG research has focused on progressive andsomewhat predictable diseases such as dementiaor cancer, which contrast with the slow declineand unpredictable exacerbations of congestiveheart failure (CHF) and chronic obstructive pul-monary disease (COPD).

Research Objective. Our objective was to exam-ine whether AG is lower among CHF andCOPD caregivers compared to cancer caregivers.

Method. Data are from a prospective, observa-tional study of 141 patient-caregiver dyads livingwith advanced cancer, CHF, and COPD. Dyadswere interviewed monthly for up to two years.Measures included the Anticipatory Grief Scalewhich measures anger, guilt, anxiety, irritability,sadness, feelings of loss, and decreased ability tofunction at usual tasks. We dichotomized AGscores and used logistic regression to examine dif-ferences in likelihoodof highAGby diagnosis, pa-tient, and caregiver factors. Aggregate growthcurve models examined change over time.

Result. At baseline, COPD caregivers were signif-icantly less likely to experience high AG com-pared to caregivers for cancer (OR ¼ 0.04,95% CI ¼ 0.003, 0.53). CHF caregivers followeda similar pattern, but the difference was not sig-nificant (OR ¼ 0.16, 95% CI ¼ 0.13, 1.05). Antic-ipatory grief levels remained consistent overtime for all diagnostic groups. Nonwhite care-givers were significantly more likely to experi-ence high AG compared to white caregivers(OR ¼ 13.04, 95% CI ¼ 10.34, 124.75); adultchild caregivers were less likely to experiencehigh AG compared to spousal caregivers (OR¼ 0.05, 95% CI ¼ 0.01, 0.25).

Conclusion. Variation in anticipatory grief isa function of disease differences and is not af-fected by location in the disease trajectory.

Implications for Research, Policy, or Practice.Interventions to address caregiver AG should tar-get specific groups that demonstrate higher