The Nurse's Role in Medication Reconciliation - BC Patient Safety ...

The Nurse’s Role in Medication Safety
• If and when the patient ever needs to be hospitalized, the updated medication
list from the primary care chart can be used with ease as the medication reconciliation/physician
initial medication order form in the hospital chart. The only
items required will be the physician signature, date, and time at the bottom of
the list, and they can be included in the admission paperwork as medications
reconciled and medications ordered, thus saving time and steps and ensuring
each patient’s medication safety.
Creating Medication Cards for Patients
While one task force of nurses was formatting the Master Medication List,
another small task force of nurses from the primary care network was designing a
medication card for patients. The hospital system trialed several tests of change in
one outpatient setting. Once again, it was necessary to enlist the help of a multidisciplinary
team composed of nurses, physicians, and patients (who were going to be
using this medication card). Not only did the medication card list the patient’s
demographics and the primary care physician’s name and telephone number, it contained
a section for the patient’s brief medical history, a place to denote
allergies/intolerances, and a grid in which to list current medications (including
herbals and supplements and over-the-counter drugs) that the patient was currently
taking. The grid also included a place to list the dose (by simply asking, “How
much?”), the route, the frequency (by asking, “How often?”), and the reason why.
(The language used was basic to facilitate teaching and learning.) This grid on the
patient’s medication card was designed exactly like the columns on the inpatient
medication reconciliation form. Soon, all patients who entered the outpatient arena
would be given instructions on how to fill out their medication cards. They were
also instructed to bring these cards with them each time they had an office visit so
that their medication lists could and would be updated, ensuring their safety. (See
the medication card for patients in Figure 1-3 on pages 21–22.)
For those patients who have not received a medication card from the outpatient
setting, a blank card is included in the paperwork for all patients who are
admitted and discharged from the hospital. Often nurses on these units assist
patients or their families with filling out the medication cards. Nurses encourage
patients to update their medication cards at discharge. The Lourdes system has
found that it only takes a few moments for a nurse to teach a patient about the
importance of the right drug, dose, route, and the reason for their medications. At
the same time, nurses can give medication-information teaching sheets to patients
and their family members. These sheets describe any new medication initiated as
well as dosage, administration, side effects, and contraindications. This is not a new
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