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

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The Nurse’s Role in Medication Safety 22 Figure 1-3: Medication Card for Patients (continued)
Chapter 1: The Nurse’s Role in Medication Reconciliation practice because pharmacies across the nation are compelled to provide medicationinformation teaching sheets for any drug that is dispensed. Medication Reconciliation in Home Care and Hospice Another area of concern for appropriate medication reconciliation was within home care and hospice. To ascertain that every patient in the system would have their medications reconciled, Lourdes’s home care agency, Lourdes at Home (LAH), and the Lourdes Hospice Program were included in the medication reconciliation process. LAH nurses reconciled their patients’ medications using a slightly different form (see Figure 1-4 on page 24). Every single time an LAH nurse entered a patient’s home, the nurse reconciled medications in the following ways: • By discussion with the patient or the family • By the discharge paperwork from the hospital • With any new prescriptions filled or unfilled • From the actual medication bottles in the home • By calling the patient’s primary care physician or local pharmacy These nurse home care visits created several opportunities for teaching and learning, while at the same time maintaining patient safety as a top priority. Similarly, Lourdes Hospice nurses relied mostly on families for the medication reconciliation, as well as on the primary care physician and local pharmacy. The hospice forms are simpler, but two strong statements at the bottom of the forms alert the patient to disclose any and all medications—including herbals, supplements, and vitamins—they are currently taking so that any possible interactions could be discussed. (See the hospice care forms in Figures 1-5 on pages 26–27 and Figure 1-6 on pages 28–29.) Implementation Including tasks in the process and documenting observations Now that the medication reconciliation forms were somewhat finalized—across the system—it was time to implement the process from the point of entry to the point of exit. On the inpatient side of the hospital system, each patient’s current medication list is computer generated every night at midnight. The nurses’ medication administration records (MARs) for their patients are also computer generated every night at midnight. During the day shift, patients (or their family members if patients are unable to comprehend it) receive their current medication list. The patient copy of the list (entitled “Postop/Transfer Medication Reconciliation Record”) is similar in 23
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The Nurse's Role in Medication Reconciliation - BC Patient Safety ...

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