Medication Reconciliation: A Key Issue in Meaningful Use

The purpose of this paper is to address the problem of medication errors in health care facilities. 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.”

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Woten (2016) attributes, National Patient Safety Goals (The Joint Commission, 2016): Medication Reconciliation – an Overview acknowledges effective communication is a driven force to accurate medication reconciling. Communication to patients, families, professional to professional provides honesty along with direction in role responsibilities. Poor communication was recognized from a study at Mayo Health system, reporting, “medical information at transition points was responsible for as many as 50% of all medication errors in the hospital and up to 20% of ADEs”(Vogenberg & DiLascia, 2013). The evidence in transitions throughout care directly connects to communication validating how medication lists, if not updated or accurate cause harm to

Self-management has become a concept adopted by the Department of Health (DH) to enable people with chronic health conditions to become the controlling entity over their illness therefore promoting independence and psychological well being. Initiatives that recommend this practice are National Service Framework for chronic disease management and self-care (DH 2002) and National Service Framework for Long-Term Conditions (DH 2005). Part of the framework plan is to implement a strategy to enable people to self-administer their own medication. This includes self-medicating in the community and in acute hospitals.

Over the past 10 years, the pharmaceutical formulary for licensed Naturopathic Physicians has absolutely expanded. In many states where Naturopathic Physicians have licensure, they also have the ability to prescribe pharmaceutical drugs to help their patients. While the Physicians may not always choose to go with pharmaceuticals as a treatment choice, they have the option if that is what they and their patients think is best. The state that has experienced the most expansion has been Oregon, but each state has its own formulary which Naturopaths can work from. If I end up working in a licensure state, it will be important to have pharmaceuticals as an option to treat my patients. My main goal as a Naturopathic Physician is to help my patients to the best of my ability. I plan to integrate pharmaceutical modalities into my clinic if it is in a licensure state, and use them for patients who need the help of pharmaceuticals. I will always strive to provide the best care for my patients, and if pharmaceuticals will help them without also causing harm, then I will prescribe them for my patients. The pharmaceutical formulary expansion provides an example of the integration of nature and modern medicine, which is the basis for Naturopathic treatment. Naturopathic treatments use natural methods whenever possible, but sometimes quicker methods are necessary, like those provided by pharmaceuticals. It is important for NDs to have a variety of treatment methods available for treatment

During the site visit I was scheduled to do medication history with patients. In the morning of the site visit, I attended to the medication history lecture and this presentation was very beneficial, this lecture made me feel well prepared and apply these skills during actual patient medication history. In the afternoon of the site visit, I got an opportunity to do medication histories with actual patients. This visit helped me have a better understand the role of an institutional pharmacist relating to medication history and medication reconciliation and why medication reconciliation is very important for the pharmacists in institutional setting. Medication reconciliation is important for an institutional pharmacist because this is a process

Francesca, thank you for your discussion. I enjoyed how you described what Jane is experiencing with her medication. What I would try to explain to her would be that each of our bodies operate in different ways. That some individual respond differently to all forms of medications and why some have allergic reactions. Therefore, it makes sense that the gentlemen that she met in the lobby has a different response than she does with a different medication. However, it in no way means that the medication that he is taking would be affective. Furthermore, I would explain that I would not recommend her to change the medication because right now it appears to be working. It appears that her system has reached complete equilibrium (Preston,

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Well the first red flag would have been when the receptionist told her she would have the doctor call her prescription into the pharmacy in Boston and when Jill arrived the Prescription was not called in. the other red flag was when she tried to page both of her physician with no response. I would have gone straight to the Emergency Department and seen a physician there and explained my situation that if I didn’t have my medication I would have seizure which could jeopardize my wellbeing. I would do exactly what Jill did and change physician as soon as I could.

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The clinical pathway of “good” prescribing in the older patient can be more extensive than younger populations. It is also over looked and can cause many problems in the elderly patients. In regards to any kind of prescription one has to have an accurate diagnosis to begin with. It is important for a physician to first and foremost understand the pathophysiology of the diagnosis so that the correct drug can be matched. Secondly the health care provider must assess the pros and cons of the treatment or to even treat the patient at all (Aronson, 2006). With elderly patients inappropriate prescribing is on the rise. Older adults are usually on multiple drugs so its important to have background information before prescribing any form of treatment. This is where it is good to limit the number of people that

In order to improve patient education regarding their medication, a quality improvement project has been designed to educate nurses on techniques for effective communication. One evidenced-based process to improve medication education and communication is utilizing the teach-back method. This educational method has been shown to improve patient knowledge and retention of information (Nurit et al., 2009). The Joint Commission, American Medical Association, National Quality Forum, American Nursing Association, and the Health Literacy Collaborative have recommended implementing the teach-back method to provide effective communication to improve protection of patient safety (Iowa Health System, 2014). The teach-back method involves educating patients about a topic and having them repeat back in their own words what they understand about the topic. By using this method, the instructor can decipher the patients' understanding of the topic. If patients cannot repeat back the information or are incorrect in their answer, this then alerts the instructor that they require more information and education. The teach-back method has been found to improve patient outcomes and protect patient safety (Weiss, 2009).

Another important reason of screening is to avoid medication errors. These errors can be fatal and risky for the patient. The risk can be significantly reduced by medication reconciliation. The process involves acquiring,confirming and documenting the list of the patient's current medicines and scrutinize this list to the ordered medicines and the patient's health to identify and resolve any variances. The best practice is to record it electronically or in writing in patient's chart or notes for the easy access for clinicians to review before writing any medication orders. The process of medication reconciliation using a structured approach involving patients provides shared accountability, can reduce the morbidity and mortality of medication

The modified AGREE II instrument, I have chosen to evaluate is Bellin Health’s Medication Reconciliation Policy. In reviewing, each of the six domains, significant positive numeric scoring reflected 6-7 within domains: one scope and purpose, two stakeholder involvement, four clarity of presentation, and five applicability. Further, modifications would strengthen domains three rigor of development, and six editorial independence. Directly looking at domain three rigor of development, evidence from reference list on powerpoint and policy is not sited within powerpoint or policy intext. I interpreted as the reviewer knowledge from reference sources was implied by creating policy and powerpoint. Therefore, medication reconciliation policy can be

M E D I A 10: U N R I V A L L E D A U T U M N E V E N T S