Re: Jcaho Medication Reconciliation Originally Posted by SEOBowhntr Recently our facility have implemented a plan of MEDICATION RECONCILIATION in which the nurse is required to provide rationales for why a physician did not continue a patient's home medications, and re-rationalize with transfers, after a surgical procedure, and upon discharge. I wondered how other facilities are doing this MEDICATION RECONCILIATION process. I have a letter at the STATE BOARD OF NURSING, NURSE PRACTICE committee right now and am awaiting a response on their stance on this issue.
I firmly believe that MEDICATION RECONCILIATION is a PHYSICIAN'S RESPONSIBILITY, not a nurses. Furthermore, nurses willing to assume such responsibility would seem to be opening themselves up to a liability issue that we as nurses really shouldn't be involved in. How are other facilities around the country completing medication reconciliation????
At our hospital, our docs/nurse practitioners are responsible for checking a box ("C" for continue and "DC" for discontinue) on the MAR and THEN they have to look at the "home meds" sheet and check "C" or "DC" (e.g., some drugs may have been on hold at admission, dosage changed, etc). Of course, some docs had to be "broken in" when this process was first implemented. It was a royal pain in the a** when it first started, but soon they became used to it. We still have to go behind them, make sure everything matches up (e.g., they may check to d/c something on the MAR, but then continue it on the home meds sheet, or they may check continue on a drug that the pt was not on at admission and then the MD forgets to leave a Rx for it when the pt is d/c'd.). Quite tedious, but I understand the rationale behind it.
Never heard anything about the rationale thing you are talking about....not really within nursing scope of practice IMHO.
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