Medication Reconciliation: A Case Study

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

Looking back on this clinical day, I would state that I effectively met my overall goals for the day - Safely and efficiently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. During medication administration, I did come across some difficulties – dropping a few pills and being unsure of the medication in the med cart – but that did not prevent me from safely administering my medication. I completed the three medication checks, while ensuring that I recognized the six medication rights. This experience sanctioned me to acquire comfort in passing meds, and permitted me to see how to prioritize time when a patient takes numerous medications. Alongside medication

My Butler University academic training and intern experience has positioned me to recognize and appreciate the essential role performed by the clinical pharmacist. Although sometimes transparent, it is the clinical pharmacist that is central to a patient’s ultimate successful recovery. This was evident during my clinical rotations, where I directly participated in the optimization of medication therapy to achieve patient-specific outcomes; it is for this reason I am impassioned and compelled to pursue a residency. As a PGY-1 resident, I plan to apply my clinical knowledge in the acute and ambulatory care settings to identify medication-related problems and make therapeutic recommendations in collaboration with other practitioners. Upon completion

M e d i c a t i o n R e c o n c i l i a t i o n : A K e y I s s u e i n M e a n i n g f u l U s e

My third and final learning point is why it is important that there is a healthcare team. As I (Ivanova, 2014, b) said in the discussion board: “In order to improve the condition of the patient, it is really important all healthcare professionals work in a team.” This is relevant not only to the pharmacist but to all health care providers, because all of them have the same goal. Working in a team makes achieving that goal easier. Good communication decreases the chances of errors. Collaboration between professionals increases the awareness of each other’s skills and knowledge, which leads to an improvement in the health care service and decision-making. Teams are formed to create respect and trust between healthcare providers and also to prevent misunderstandings. The healthcare team should be centred on the patient and also making him feel better and improving his quality of life. Not having a team may result in serious errors and argues due to lack of communication. This is clearly not the point of the health care service. The interprofessional learning activity enabled us to understand the importance of having a team in healthcare and that coordination between all professionals is required in order to get the best effect from the treatment of the patient.

As future pharmacists, we are going to face with not only the medications but also the patients, which the former ones are our tools while the latter ones are the people we use correct tools to care about. We are required to combine our pharmacy knowledge among medications with patients’ different health conditions to create the patient-centered care and provide the best outcomes. However, this care trend is in transition now, from professional-orientated to patient-centered.

During the two and a half years of my pharmacy journey, I have been thinking what can a pharmacist do within the healthcare interprofessional team to better help the patients in order to achieve the best health outcome. I work in a clinic as well as inpatient pharmacy, additionally, I had my rotations at CVS and Regions Hospital. all these experiences shape my version of the pharmacists at different settings. Therefore, in various pharmacy settings, pharmacists can work differently with the whole healthcare team. The recent PED-Rx events inspired me how important pharmacists can play roles in when working in a team.

As part of my third-year pharmacy practice module which I study at the university of Huddersfield, I just finished a New Medicines Service (NMS) exercise. The aim of this exercise was for those involved to consider communication skills, adherence to medication taking and the application of the NMS. Those involved included pharmacy students in their first year of study and students in their third year of university, with the first years acting as patients and the third years acting as the pharmacist.

There are many challenges during the process of medication reconciliation. Some patients are taking herbal supplements that they forgot to mention during the interview, some of them do not take all medications that are on their list for different reasons, and errors made during transfer of care reconciliation, are just a few examples how this problem is serious and can cause potential harm, even death in some cases.

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

Our health care environment is faced with the patient safety issues, shortages on health and human resources, increasingly complex health care needs. Before coming to activity I expect that Interprofesional activity is a way of bringing all the perspectives of different healthcare professionals to improve patient safety. During the activity I found the role of a mental health counselor might treat a patient who has been the victim of domestic abuse, individuals struggling with poor self-esteem, helps individuals and families deal with difficult emotions, in a variety of settings, including schools, hospitals, private offices and clinics, and substance abuse treatment facilities. On the other hand, Pharmacists can play an active role in treating

Administration of medicines is a key element of nursing care. Every day some 7000 doses of medication are administered in a typical NHS hospital (Audit Commission 2002). So throughout this essay I will be evaluating and highlighting the learning that took place whilst on placement at a day unit.

If I were to walk down the hallway and hear a fellow nurse making the statement that they are trying to administer medication, and the cannot complete the task because the medication administration program is telling them wrong patient my first action would be to ask that nurse if I could assist her is finding a solution. Hopefully that nurse would allow me to assist. Then I would be able to check the chart and the patient’s identification band manually. If it was not the correct due to patients having similar names such as James Stewart or Stewart James, then the problem would be easily solved by selecting the correct patient’s chart. However, if the patient’s identification bracelet is correct and matches the selected patient’s HER, then

The reconciliation should be used in every transition in care, where the new medication is prescribed and old mediations are rewritten. The accuracy of the list can prevent many drug effects and interactions; therefore it is important to ensure proper documentation and communication at all levels of care. Also, many errors occur when doctors fail to write out necessary orders such as, “resume pre-op medication.” The use of this “resume pre-op medication” has been prohibited by the Joint Commission due to the many complications it can produce including increasing the chances of adverse effects. Furthermore, it has been discovered that most discharged patients have been found to have insufficient knowledge regarding their medications upon returning home (Joint Commission, 2006). Medical reconciliation provides the patient with crucial information regarding the dosage, route, therapeutic effect, and reason for administration.

Today in the 21st century the roles of pharmacist have expanded tremendously. Before pharmacist had the role of solely dispensing drugs. Pharmacists were limited to only being regulatory or clinical pharmacist. Back then they were called medical purveyors who were much like today’s regulatory pharmacist and hospital pharmacist who are similar to hospital pharmacist. Now pharmacists carry many roles in healthcare. Pharmacist can play roles in public health, community, health systems, state, and federal government.