Use of Electronic Medical Records

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

Discrepancies in patient’s medication reconciliation (MR) can have consequences that are potentially lethal. While many of these discrepancies are potentially avoidable, facilities are not utilizing all of the resources readily available. With evidence-based practice (EBP) guidelines in place it is possible to improve the medication reconciliation process, and provide safe care to patients across all transitions in healthcare. The purpose of this paper is to show improved medication accuracy, during the medication reconciliation process, through increased collaboration between Advance Practice Nurses (APN) and pharmacists.

Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of

For the purposes of this integrative review, an acute care setting is defined as an adult general medicine medical surgical unit. The expected outcome of the integrative review will be to discover a strategy, intervention, or protocol that can be implemented within the project leader’s healthcare organization to support a sustained change. Upon dissemination and implementation of the findings, a systematic evaluation can be conducted to determine the positive or negative outcomes of the intervention. Each year in the U.S., serious preventable medication errors occur in 3.8 million inpatient admissions and 3.3 million outpatient visits. The Institute of Medicine, in its report To Err Is Human, estimated 7,000 deaths in the U.S. each year are due to preventable medication errors. Inpatient preventable medication errors cost approximately $16.4 billion annually. Outpatient preventable medication errors cost approximately $4.2 billion annually. Dosing errors make up 37 percent of all preventable medication errors. Drug allergies or harmful drug interactions account for 11 percent of preventable medication errors. Preventable medication reconciliation errors occur in all phases of care: 22 percent during admissions, 66 percent during transitions in care and 12 percent during discharge. Approximately 100 undetected dispensing errors can occur each day as a result of the significant volume of medications

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.

The purpose of this paper is to bring forth awareness when it comes to patients and medication errors and further educates health care professionals on the importance of communication especially during transition of care. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although not all medication errors occur during transition it is the time most prevalent for these errors to occur. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transition of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.”

Medication error is defined as the following by the National Coordinating Council for Medication Error Reporting and Prevention: “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling; packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use” (Anthony, Wiencek, Bauer, Daly, & Anthony, 2010). Medication errors cause increased length of patient hospitalization and morbidity and mortality (Pape

In most organizations, a review of the most recent medication errors will likely uncover some aspect of an ineffective double-check process. Take the time to evaluate the procedures for which you require a double check, monitor compliance, assess how often the checks are conducted as designed, and then make the necessary revisions to promote effectiveness. When employed judiciously, conducted properly, and bundled with other strategies, manual independent double checks can be part of a valuable defense to prevent potentially harmful errors from reaching patients

Medication mistakes is a critical global issue and the utmost principle widespread dilemma that terrorizes patient safety that might spearhead to disability or death if not detected, and medication error are virtually never deliberate and regrettably occur in healthcare

Multiple outpatient care providers and polypharmacy contribute to what the patient may be taking and documented medications. 22 studies found that errors in prescription medication occurred in 67% of patients that arrive at the hospital with up to 59% of these errors deemed to be clinically relevant. ("Health care system vulnerabilities: " n.d.) Long term medication the patient is taking on a regular basis is the most common form of unintended discrepancy. The most accurate way of knowing correct history is to have all medication in the patient physical possession.

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 new federal healthcare laws are now requiring clinics and hospitals to focus more on medication reconciliation. This is an improvement, but it will take a combined effort of healthcare providers and patients to make this successful. Another helpful application is the creation on the Prescription Monitoring Database. This database has been created in the effort to allow healthcare providers a resource to simply key in some of their patient’s basic information, such as name and date of birth, and review a patient’s prescription medication history particularly narcotics. While this database is not completely “fool proof”, it is a concerted effort in the battle against prescription drug

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

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.