Summary: The Process Of Medication Reconciliation

Outcome measures assess whether the interventions to improve medication safety practice will be successful. During the interview of the new employee, competency evaluation related to medication administration will be applied first. In addition, during the orientation for these new employees, adequate training will be provided to ensure the importance of preventing medication errors. They will be given a list of similar and look-alike medications and will focus on medications that cause the most adverse reactions when errors may occur. Then, after training and when staff start working, they will be supervised during their first few months. When they are not supervised, they will be assessed and evaluated for any errors. During this process,

HCS Med 360 is a software solution used to support medication reconciliation. This technology allows the consulting pharmacists to rapidly query over a dozen national databases and see the patient's prescription fill history as well as gaps in the fill history. Experience to date shows that this robust system captures all prescription medications in Hawai‘i except those filled at Kaiser or the VA and those paid 100% self pay. The consulting pharmacist then completes the reconciliation process and produces a current medication list, including OTC medications, herbals, and supplements. The fill history and complete medication list are being built so that this information can be included in the patient's HHIE Community Health Record. The HHIE

The projected process improvement is to only perform medication reconciliation in the outpatient EHR versus performing this task in the legacy Composite Health Care System (CHCS) system. AHLTA and CHCS are incompatible for the medication reconciliation; this known flaw in the system creates opportunities for medication errors and is considered a patient safety issue. This is an important issue to fix because it has been shown in studies that “Adverse drug events (ADEs), defined as harm

Due to the large number of consumers being prescribed multiple medications, and the complexity of managing those medications, it is of a major safety concern that systems are in place for clinicians to reconcile patients medications to resolve any discrepancies in what the patient is using, or should be using, and newly added ones.

As it is mentioned earlier, medication administration includes various steps and an interdisciplinary team. Undoubtedly, nurses play a vital role in the medication administration process. Since patient safety is the priority to all health care professionals, it is important for the nurses to effectively communicate and collaborate with an interdisciplinary team if he or she is unsure about any medication prescription to prevent any adverse events. In addition, patient education is another component of safe administration. A patient must be educated on medications they are taking, the reason for taking them, the dosage, a route, potential side effects, and interactions. Nurses should perform “six rights” of the medication each time. Before administering

Surescripts collects data from the pharmacy which is available to e-prescription. This provides physicians with information on medications patients paid out of pocket by insured and uninsured patients. When physicians collect a comprehensive medication history, this can enhance physicians to use the Surescripts e-prescription feature for medication reconciliation. A comprehensive medication history may improve drugs interaction alerts which decreases the chance of medication errors and the number of duplicated

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

A conflict with any medication that the individual has or is previously taking. Ingredients that forms the medication are also examined vs. the ingredients of recent drugs to find out if they would clash with one another or if they would hamper the influence of the medication. Medications are also examined to see if there is duplicate therapy, which takes places when the individual is taking another medication in the same exact class and the medication could result in the individual having an overdose. Furthermore, allergy records are examined to see if the individual has food and drug allergies that could possibly be provoked by the new medication. The individual’s diagnosis is examined to make out if the individuals has a medical condition

Medication reconciliation is defined as a “formal process of obtaining a complete and accurate list of each patient’s current home medications – including name, dosage, frequency, and route – comparing the physician’s admission, transfer, and discharge orders to the list.” (Meguerditchian N, Krotneva, Reidel, Huang, & Tamblyn, 2013). There have been several studies performed across the world to try to comprise a system that will successfully accomplish medication reconciliation. Some of these studies have been successful and others have failed to find a solution. There have been studies that have utilized a pharmacy technician in the emergency department to facilitate the input of patient’s medication reconciliation prior to admission. Other studies have relied on the pharmacist to obtain the information. Most studies involved the primary nurse providing care to the patient to obtain the medication reconciliation information. There have been several forms of documentation tried on trial bases. These forms of documentation range from a paper medication administration record (MAR) to an electronic medication administration record (EMAR) that utilizes today’s technology.

Bar-coded medication administration (BCMA) systems are also commonly used by nurses to improve medication administration in inpatient settings. As an illustration, a study in 2007 showed that BCMA systems reduced medication administration errors by 54-87% in hospitals in the US. It has been reported that a large number of medication errors happens at care transition points, i.e., during admission, transfer and discharge of patients. Thus, medication reconciliation at all transition points could significantly improve medication safety. In fact, preliminary evidences suggest that application of electronic medication reconciliation systems are quite effective in reducing such errors. Additionally, electronic personal health record (EHR) systems can be used to reduce medication errors. These IT systems allow patients to access, coordinate their health information and make it available to their healthcare providers. IT systems are also used to reduce medication errors of omission. As an example, recent studies have demonstrated that smart electronic discharge systems utilized in some hospitals can alert physicians to prescribe important medications.

Mediation reconciliation is the process of gathering all the medications, including over the counter meds, herbal supplements, and multivitamins a patient is taking regarding their care. Within the parameters of mediation reconciliation, dosage, frequently, name,and route are the prime factors of developing a medication regimen. The goal of knowing all medications of a patient before continuing with care or being admitted to specialized settings like hospitals or clinics will avoid over-medicated adverse effects and possibly death. According to the article, Medication Reconciliation to Facilitate Transition of Care after Hospitalization states that, “ It is estimated that 20% of patients experience adverse effects during the two weeks after hospital discharge (2015). With that in mind, image ho many patients experience this disparity throughout their lives with the advised medications given at the hospital. The nurse, as well as the patient and their families should be encouraged to be more involved in their care to avoid inadvertent inconsistencies across the transition of care between admission, transfer, and discharge from and to specialized settings. Aside from preventing medication errors, we as nurses, can support the patient 's safety as the first line of defense in battles against unsanitary and explosive adverse effects that results from inadequate nursing skills.

Medication history is nothing more than a detailed, accurate and complete account of all prescribed and non-prescribed medications a patient might have taken or is presently taking upon to the arrival to the acute care institution. One of the challenges in the process of completing the medication history, is the ability to obtain pertinent and valuable information in a timely manner as this provides valuable insight in guiding appropriate treatment and care during the emergency situation. Doing so in an effective manner can help prevent medication errors and consequent risks to patients. Another challenge is the lack of technology integration across the national healthcare system which poses significant difficulties in obtaining accurate information from a variety of sources in a timely manner. Regulatory and accreditation bodies have made it a requirement that healthcare systems focus on improving the medication reconciliation across the continuum of

The purpose of this project is to decrease potential medication errors in the facility. This will be done by following some strategies:

Medication errors are a reoccurring issue that has plagued the medical field since the beginning of drug administration. In order to understand how to handle medication errors, one must first understand what a medication error is. The concept of medication error can be defined as: “any preventable event that may cause or lead to inappropriate medication use or harm to a patient” (Kee, 2012, 125). Examples of medication errors include: misreading a patient’s medical file, not clarifying illegible prescriptions, an incomplete patient assessment, confusing look-alike and sound-alike medications, and lack of better understanding if a medication can be crushed or split. To better understand medication errors and medication safety one must understand the impact it can have on the medical community and patient care, ways to prevent medication errors, and what should be done in a situation where a medication error has occurred.

According to the Institute for Healthcare Improvement, “Medication reconciliation is the process of creating the most accurate list possible of all medications a patient is taking — including drug name, dosage, frequency, and route — and comparing that list against the physician’s admission, transfer, and/or discharge orders” (Institute For Healthcare Improvement, n.d). This process includes three steps: collecting the medication history, ensuring that the medications and dosages are appropriate for the patient, and documenting the changes in the orders. This occurs when the patient is admitted, transferred and discharged from the hospital (Institute for Healthcare Improvement, 2011). The purpose is to avoid any duplications, incorrect