Reflection On Medication Reconciliation

In a similar case, “ASHP Guidelines on Preventing Medication Errors in Hospitals,” was experienced prescribing error incorrect drug or instructions for use of a drug product ordered or authorized by physician; illegible prescriptions or medication orders that lead to errors that reach the patient (1993). Another problem that might occur at the doctor’s office the doctor might misunderstands the patients concerns or symptoms and misdiagnose the patient. Sometimes accidents might occur and the patient might not get well and goes back to see the doctor and the doctor to correct their mistake. When mistake takes place there should be a monitoring and managing action plan should be put in place. An appropriate and correct statistical thinking required to apply the statistician’s finding for improving the prescription process by the pharmacist in this process is lacking and that is the root problem for the prescription issue in this process. Another problem that ties in with this problem is the doctor handwriting; the person that enters the prescription may not understand what it says. They assumes it says something totally different written and that is another reason why it is important for the verification of the prescription with the doctor. The problem is a common-cause variation as the right statistical thinking is the inherent requirement of the prescription process (Horel & Snee,

It’s not simply the particular giving of the medications that fare up all the time. It is checking the medical record with the hand written prescriptions, grouping the varied medications and also the instrumentation for giving them, and ensuring all the patients safety measure are covered.

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

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.

Improve the safety of using medications. The findings were that often medication error were made because medications and other solutions were removed from their original

Medication Reconciliation is defined by the Joint Commission as the process of checking and rechecking a patient’s current medication list to the patient’s orders. Within a MedRec program, three steps must be followed to ensure patients have the correct medications at admission and discharge: Verification, Clarification, and Reconciliation (Greenwald et al., 2010; Ruggiero et al,. 2015). MedRec should not occur once, but multiple times especially when a patient moves from department to department. The more a patient moves, the more liable they are for a medication error due to poor communication. MedRec is done for the simple reason of catching those medication errors and correcting them before they can do any harm (The Joint Commission, 2006). Medication errors effect nearly 1.5 million people who enter the hospital setting in the USA. At least every patient has one medication discrepancy between admission and discharge, which leads to rehospitalizations due to hospital-setting medication errors (Institute of Medicine as cited by Wilson et al,. 2015). With nurses at the forefront of a patient’s medication regime, pressure is put on them to provide the necessary education and safety to prevent medication related rehospitalizations. Included in the causes for medication errors is miscommunication between departments taking care of the same patient (Allison et al., 2015). Many medication errors are preventable by the implementation of electronic orders. The use of electronic

The SCHC addressed meaningful use by recording patient demographics, maintaining an active medication lists and incorporating clinical lab test results into the HER, as apart of their meaningful use objectives. For recording patient demographics, they maintained data for accurate billing and ensured that the practice workflow was adjusted to capture all of the necessary patient data. They addressed active medication lists by following the requirements for e-prescribing. Patients were able to review their active medication list during their visit. Changes to the medication list were reviewed with the nurse and adjusted within the EHR system by the doctor. They communicated information for the care coordination process by making test results efficient and safe to access. Physicians were able to make real time decisions when they receive the test results from LabCorp, Quest, and other health

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 PC will randomly select 25 participants, aged 65 years and older, who are patients in a primary care setting, who have at least one chronic disease, are Haitian Creole speaking only, and who take more than five medications daily. Those patients will meet monthly and will bring their pill bottles for medication review. Two Haitian Creole speaking pharmacists will be recruited to participate in the program. They will gain access to the participants' electronic health records (EHR) for the duration of the program. During each visit, the pharmacists will inquire about participants' medication use including over the counter medications, reason for taking the medications, the duration of the treatment, the use of different providers, and participant's

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.

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 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.

Many medication errors comes from miscommunication between the physicians, pharmacists, and the nurses. As nurses, we should eliminate these barriers of communication and always verify drug information, and also communicate among team members. The most effective way to promote communication among our colleagues at work is to use the “SBAR” method which means situation, background, assessment, and recommendations. I read a journal at American Nurses Association website about a patient who died because of poor communication among team members. A patient died after labetalol, hydrala¬zine, and extended-release nifedipine were crushed and given by NG tube. Crushing extended-release drugs allows the entire dosage to be absorption immediately. As

28 out of 86 cases, administrative mistake were made, 3 cases was due to confusion and the rest of cases were due to decision by the patient. There were 92 medicines involved, 51 were no longer being

Polypharmacy, an amount of medications exceeding the number of medically indicated, continues as a major problem in the medical community. Certain factors like age, race or ethnicity, socioeconomic status, and clinical condition can increase a patient’s risk of having an excessive medication list. The increase in popularity of over-the-counter medications and herbal supplements also adds to the problem. Adding a medication increases the chance of a drug-drug interactions, side effects, or non-adherence to taking medications. All three problems pose significant problems in helping patients make functional goals of treatment and hamper a patient’s quality of life.