Medication Reconciliation Are all hospitals doing this?

  1. Is this a universal thing these days? I was talking to a traveler the other day and he said that many places of doing this.

    Is this going to turn out to be just another useless form, or has anyone seen some concrete positives come out of it. There've been some problems where I work. The nurses are hurrying to get the forms done, some of the docs are blindly signing them off. I notice it's a bigger problem when the admiting doc is not the primary doc for the pt. Also, some of the older pts are tinkering with their prescribed doses at home, they give us the info, we write it on the med-rec sheet, the admit doc takes it as the gospel, and then there is an error. I had a pt who ended up being over metropolized on a double dose which he had also been mistakenly taking at home. He was having some pretty significant non sustained bradycardia, and when I called the primary he said that the dosages, which had been taken off of med-rec by pharmacy, and had been incorrect.

    My point being that med-rec is sometimes creating more problems than it's solving. Also it's timeconsuming. I haven't given up on it yet, but I'm losing hope.
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  2. 34 Comments

  3. by   SCRN1
    We have to do it where I work. I'm not really sure what extra purpose it's doing when we also send the MAR with the same info on it when a patient leaves the floor for another area of the hospital.
  4. by   hogan4736
    Can you say JAAAAAAAAYCOOOOOOOOOO...

    lol

    someday (I pray) we will look back on these JCHAO days, and just laugh)

    They are telling us and mandating things that we should have been doing all along...
  5. by   P_RN
    That's what I was thinking. This is something I have been doing forever and a day.
    In addition to family/patient memory, I've called pharmacies, PMPs etc. to try to get an idea what the little white pill with the words or is it numbers on one or both of the sides.
    I carry a Universal Medication Sheet as I myself can't always remember all my meds.
  6. by   TazziRN
    What's annoying at my place is that the ER has to do it too, but many of our pts are on only a couple of meds and the information fits on the chart. Can we just get away with doing that ? NooooOOOO! Even for that we have to fill out the stupid form.
  7. by   ChiaLing
    I thought that medication reconciliation was one of JCAHO's National Patient Safety goals. Shouldn't all hospitals be doing this?
  8. by   tattooednurse
    I work in a busy er and it is hard enough to get someone d/c'd without another piece of paper that the pt doesn't look at
  9. by   BrnEyedGirl
    Medication Reconciliation has been part of our routine for at least 11 years now,....I have also spent hours on the phone w/a local pharmacy, or PCP's office, or even the neighbor who can go inside and read the bottle labels to me,...Our ER doesn't do these sheets as they don't routinely give home meds. We do this on admit w/home meds and then every night at 2300 w/ the MARS,..and we can no longer accept an order for "continue home meds", they must be written out or pharmacy won't dispense them!
  10. by   nursemary9
    Quote from ChiaLing
    I thought that medication reconciliation was one of JCAHO's National Patient Safety goals. Shouldn't all hospitals be doing this?

    That's what I thought, too. We have been doing it for sometime, but about a year ago, they changed what we do & it is much more detailed & takes ever so much more work.

    However, I can see where it could be an excellent form---it just takes so DARN long to do---any many calls to various places.

    Mary Ann
  11. by   Nursonegreat
    We just started using these forms as well, and i am told they are not required by JAHCO yet, but they will be. i work in an ambulatory surgery center, not affiliated with a hospital, so not just hospitals will have to do them. does anyone have a good form they used/downloaded? we created our own and added spaces to mark when i speak to the patient preoperatively which meds we recommend holding and also taking on the day of surgery. this process seems to be taking an extra amount of time per patient. anyplace to look at mock forms or downloadable forms for comparison?
  12. by   DusktilDawn
    We are now doing medication reconciliation forms. The problem at my facility is that the residents are supposed to be filling them out, and the ones covering the surgical GPUs are not doing them because they "don't have enough time." I can see this being dumped on the nursing staff since we don't have the luxury of claiming to not "have enough time." It is one of JCHAO's recommended National Patient Safety goals.

    The goal is to increase the extent to which pharmacists help individual hospital inpatients achieve the best use of medications.

    Objectives include:
    Pharmacists will be involved in managing the acquisition, upon admission, of medication histories for 75% of hospital inpatients with complex and high-risk medication regimens.

    The medication therapy of 100% of hospital inpatients with complex and high-risk medication regimens will be monitored by a pharmacist.
    In 90% of hospitals, pharmacists will have organizational authority to manage medication therapy* in collaboration with other members of the health-care team.

    75% of hospital inpatients discharged with complex and high-risk medication regimens will receive discharge medication counseling managed by a pharmacist.

    50% of recently hospitalized patients (or their caregivers*) will recall speaking with a pharmacist while in the hospital.

    2015 Goal 1:Increase the extent to which pharmacists help individual hospital inpatients achieve the best use of medications.

    and we can no longer accept an order for "continue home meds", they must be written out or pharmacy won't dispense them!
    A physician writting "continue home meds" isn't an acceptable order IMO, and shouldn't be accepted by pharmacy. Technically it puts the nurse or pharmacist in a position of prescribing medications which IS NOT within their scope of practice.

    I've always recommended to patients to carry a current, up-to-date list of medications, allergies, health conditions, and past surgeries. What I don't understand is that when a person goes to a pharmacy to have their prescription filled, why that pharmacist dosen't provide a list of the medications the patient is on and inform the patient why they should carry such a list?
  13. by   nursemary9
    [

    I've always recommended to patients to carry a current, up-to-date list of medications, allergies, health conditions, and past surgeries. What I don't understand is that when a person goes to a pharmacy to have their prescription filled, why that pharmacist dosen't provide a list of the medications the patient is on and inform the patient why they should carry such a list?[/quote]


    We have a Med Card we have to make for every D/Ced pt. all the current meds, dosages, frequency are listed as well as a Pt's allergies.
    I have a list as you describe in my wallet & have made lists like these for my DH & my Mom.
    Also, right along with that, I carry a copy of my Advance Directives; I actually also carry a copy of my Mom's since I am her POA for Health Care.

    Mary Ann
  14. by   DusktilDawn
    Quote from nursemary9
    We have a Med Card we have to make for every D/Ced pt. all the current meds, dosages, frequency are listed as well as a Pt's allergies.
    I have a list as you describe in my wallet & have made lists like these for my DH & my Mom.
    Also, right along with that, I carry a copy of my Advance Directives; I actually also carry a copy of my Mom's since I am her POA for Health Care.

    Mary Ann
    When I admit a patient that carries lists like these, it makes my day!!:spin:

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