Meeting CHF core measures with medication reconciliation upon discharge - page 2

I am currently in an RN to BSN on-line program. I am completing my practicum requirement on a telemetry floor. I have an assignment for school to correspond with another nurse in another region about a current issue in my... Read More

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    The med recs do get done but it can be like pulling teeth. To add yet *another* form (such as for core measures) that needed to be filled out at discharge would be very strongly resisted by both physicians and nurses. And I can see why. They've got various forms coming out their ears! That's why I'm asking how Anna5N's facility is managing compliance with their core measures discharge form.

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    Quote from jjjoy
    The med recs do get done but it can be like pulling teeth. To add yet *another* form (such as for core measures) that needed to be filled out at discharge would be very strongly resisted by both physicians and nurses. And I can see why. They've got various forms coming out their ears! That's why I'm asking how Anna5N's facility is managing compliance with their core measures discharge form.
    Needless to say the doctors were not happy when this first rolled out but they have realized that they do not have a choice. We are an advanced chest pain and CHF center so the heads of those programs started by doing alot of education with the physician groups. Our medical directors are on board and if there is any resistance met by a physician it is reported to the medical director and they deal with the individual physicians. We are allowed to fill out the form for the physician if we go over it on the phone with them so we have to ask them if they want the patient on an ACE/ARB, Beta, ASA, Plavix, Statin, etc and if not they have to give us a rationale such as renal insufficiency, bradycardia, etc. Sometimes it still feels like we are babysitting the physicians to remind them to fill out the Med Rec and Cardiac Discharge sheet but it seems to be getting the job done.
    jjjoy likes this.
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    Sounds exactly like my unit! I'm still very new, just off orientation and I find that this is quite a hassle and most nurses on my floor will agree. The nurses are always held responsible, the MD's are not. It's a rather unfair standard...
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    Good to know so many of us share the same problems. My hospital has a core measures team to follow all issues related to core measures (AMI, CHF, Pneumonia,SCIP, etc). Unfortunately this "team" is comprised of administrators and other non-clinical nurses (those who have not been at the bedside for years). Instead of loking at the overall process problem, they keep putting a band aid on each time an issue comes up. In addition to the bedside nurse having to deal with all of the paperwork and holding the MD's hand during the discharge, they also have to worry about making any mistakes. If the core measures team identifies a failure the responsible nurse gets a disciplinary point assigned and couseling. These disciplinary points are permanent, they do not roll off after a period of time.
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    I go through the same process that you are describing at my job. I love the idea of having the pharmacist doing the discharge med rec. They would be better equipped to locate any possible problems. I'm a new nurse and I hate that all of the paper work takes away from my patient contact.
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    AnnaN5 do you have a copy of the CHF discharge sheet, we're trying to implement something similar at my hospital


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