As defined by the Institute for Healthcare Improvement (IHI 2015) and National Institute for Health and Care Excellence (NICE 2015), medicines reconciliation (medsrec) ‘is the process of identifying an accurate list of a person's current medicines and comparing them with the current list in use, recognising any discrepancies, and documenting any changes, thereby resulting in a complete list of medicines, accurately communicated’. It has been shown on many occasions that uncorrected discrepancies during medsrec contributes to medication errors on discharge. As a result, medsrec is now a compulsory process and forms part of the discharge planning in compliance with NICE, Department of Health (DoH), RPS and local policies. NICE guideline (NG5) …show more content…
(2013), supports this as they indicated that 50% of adverse drug reactions (ADRs) are avoidable with appropriate medsrec. Their study found that up to three professionals from two disciplines were involved in the medicines reconciliation process including doctors, pharmacists and nurses, with geriatric medsrec taking most of the time. The research used a time and study motion design for its methodology which should have served as an advantage as staff were being monitored under normal working conditions but this was not so as staff were consciously under or over performing when they were being timed. This variation in performance levels was influenced by their attitudes towards the goal of the research as under or over performance by staff was purely based on staff wanting researchers to assume and think that the medsrec process was done appropriately or not at the right time. In addition to this, the study was limited to the normal working hours of the hospitals and omitted weekends, nights and evenings to show medsrec being done in ideal staffing conditions. The result could have been different during outside of the normal working hours of the hospitals due to different working conditions such as the availability of staff involved in the medrec process, for example, pharmacists and Fy1/Fy2 doctors. This will be the focus of my own study as the medsrec process may be different during out of pharmacy hours. On the other hand, one advantage of the study is in the direct and continuous observations of staff which gave the researchers insight into the roles and responsibilities of different healthcare professionals (HCPs) involved in the medsrec and discharge process. This will provide a benchmark to the effectiveness of the discharge process and give room for improvements where
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,
This journal talks about it takes failure to resolve medications across changes in care is an important cause of harm to patients. There is not a lot to known about medication discrepancies before patients are admitted to a skilled nursing facilities. To describe the prevalence of, type of medications involved in, and sources of medication discrepancies upon admission to the SNF setting. Cross-sectional study. Patients admitted to SNF for subacute care. Number of medication discrepancies upon admission to the SNF setting. Cross-sectional study. Patients admitted to SNF for subacute care. Number of medication discrepancies, defined as unexplained differences among documented medication regimens, including the hospital discharge summary, patient
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
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
In order to evaluate and compare medication compliance the patient’s discharge medication reconciliation were compared to patient’s medication list at time of first office visit. Of the patients in population 1 (N=82), 71 were seen back for follow up and 11 never returned. Of the 71 that returned for follow up 97.18% (N=69) were compliant with discharged core measure medications. Population 2 (N=104), 97 were seen back for follow up with 7 never returned. Of the 97 seen back for office follow up 100% (N=97) were compliant with discharged core measure medications. Statistical analysis of the two population did not find a statistically significant difference (p= 0.0991).
In Australian hospitals medication administration errors make up 9% or 1 in10 of all medication administrations. These errors include wrong doses, wrong intravenous infusion rates and errors made by prescribing doctors. Errors on discharge of patients were increasingly higher with up to 2 errors per patient related to doctors transcribing discharge medications (Roughead, Semple, & Rosenfeld, 2016).
The medication reconciliation process compares the medications taken by a patient prior to admission to a facility with medication orders at the facility. The Joint Commission (TJC), the accrediting body for health care organizations, stipulates that the medication reconciliation process must be completed within 24 hours of admission (Sentinel Event Alert, Issue 35, 2006). This process begins with compiling an accurate list of the patient's home medications which are also referred to as prior to admission (PTA) medications. At Poudre Valley Hospital, it is the job of the Pharmacy Admission Specialist (PAS) to compile and verify this list. The PAS must collect, record and communicate to the provider an accurate list of the patient's
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.”
In addition to telephone and clinic follow-up, medication reconciliation has been identified as critical transition of care intervention. Gunadi et
The activity that I performed and relates to this outcome is medication reconciliation. I performed this activity in my IPPE-III class as a PS-III student. It was a mandatory activity, which I carried out in workshop in the group of 4 students. In this activity, we were given a patient case, which had list of all the medications that patient was taking and had patient’s demographic information. After reviewing patient’s given information, I had to interview a standardized patient and find out if the patient is taking all the medications as directed by prescriber or not. If patient is taking any other vitamins, herbal or OTC medications that is not on the list and also had to look out for if there is any discrepancy with the medications patient currently on for example, duplicate therapy, drug-drug interaction, incorrect frequency etc.
As a leader in the workplace, medication errors mostly occur when the workplace is understaffed with a patient load of full nursing cares that require more attention and care than patients who are independent. Due to being understaffed with a patient load of 13 to 2 nurses, medication errors occur more often as nurses are being rushed to finish all cares within their work timeframe. To decrease medication errors it is important to implement more staff during medication rounds, thus giving nurses additional time to concentrate and assure that the correct medication and dose is being given to the right patient ( ). The 6 medication rights are important to implement into every workplace as it decreases the chances of administrating medication to the wrong patients ( ). The medication right include; ______________________________________________________________ ( ). Medication errors have important implications for patient safety and in improving clinical practice errors to prevent any adverse events (
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.
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.
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
The ability to provide safe and quality healthcare to Australian Consumers is a fundamental process within all healthcare institutions (Steinwachs & Hughes, 2008). Such processes require the input of functional strategies at both an organizational and nursing level, in order to achieve desired health outcomes (Steinwachs & Hughes, 2008). The collection and assessment of data is an integral step within this process, as this allows for weaknesses to be identified and improvements to be made in the delivery of care (Clarke & Donaldson, 2008). The following essay will discuss the core business of health institutions within Australia. It will highlight the importance of process data and outcome data, in order to ensure quality and safety in healthcare. The collection of process and outcome data on the effectiveness of completing medication reconciliation during patient care, in order to reduce medication errors, will be drawn upon as an example to demonstrate this understanding.