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

The Nurse’s Role in Medication Safety
implemented medication reconciliation from admission to discharge to avoid any
confusion with nursing and physician documentation, especially because documentation,
by its nature, is ever-changing. National Patient Safety Goal 8 was reiterated
throughout the organization. The words medication reconciliation were incorporated
into most meeting agendas and discussed in most conversations.
Planning
Statement of the specific goals, action plans, and outcomes for patient safety
National Patient Safety Goal 8 defines the purpose of medication reconciliation,
which is to avoid errors of transcription, omission, duplication of therapy, and
drug-drug and drug-disease interactions. The Joint Commission answers the question
as to who is supposed to complete the medication reconciliation process in its
Frequently Asked Questions, which are posted on its Web site. 2 According to the
Joint Commission, there are the following two models:
1. The physician completes the medication reconciliation process when he or she
writes the orders.
2. The pharmacist or nurse completes the medication reconciliation process before
preparing or administering the medications, and then notifies physicians if any
concerns arise.
The team decided that throughout the Lourdes Hospital system every nurse
will ask each one of his or her patients, on admission to the patient care unit, for a
list of the medications they are currently taking and will fill out a medication reconciliation
form accordingly, with a “good faith effort to obtain as complete a list
as possible, within 24 hours or less.” 1 Besides the actual medication, the nurses will
include the following information: dose, route, frequency, reasons for taking the
medication, and the time of the last dose taken.
Creating the Medication Reconciliation Form
The hospital system designed the medication reconciliation form to be used
as a physician order form. (See the Medication Reconciliation/Physician Initial
Medication Order Form in Figure 1-1 on page 17.) After the physician indicates
whether he or she wants the same medications to be continued or stopped, or if
the medications have been ordered by the physician elsewhere on previous order
sheets, the form can be used as an official physician order form. In addition, the
form contains language that indicates how to use the form and that
“herbals/naturals and supplements will not be dispensed to inpatients.” It references
Lourdes Hospital’s Patient Care Services Policy #29, which states that “all
products not regulated by the Food and Drug Administration (for example,
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