Medication Reconcilliation- An ER responsibility?

[DJ-Adia]

Our Medical/Surgical unit was informed yesterday that the Emergency Room was nolonger addressing the medication reconciliation forms seeing as though it is too time consuming. I was under the understanding that Joint Comission had enforced the Med Rec forms as a strategy to maximize patient safety as it relates to the medications they take on a routine basis. I feel that the ER should be asking about meds & their doseages to reveal if the patients presenting complaints could be related to a side effect or a contibuting factor causing a medication interaction. To avoid this step during triage - could the healthcare professional be held liable if a "medication-related" precipitating factor was misdiagnosed which resulted in a lengthy inpatient stay?

In Addition, the majority of families that accompany a patient to ER "ususally" bring in the medication bottles and often times leave before the patient is transferred to our unit. Not only do we not know the medications - but also are at a loss in completing the Med rec without accurate information. Has anybody experienced a similar situations?

[mkhaneja]

We use MediRecon (http://www.medirecon.net) and the ER does the starting medication reconciliation online. Therefore, no forms to deal with, and its easy to use. In general, it is the duty of the ED to do their part, but many ED's will just setup the home med list only. Not much more than that.

[Charity, RN, APRN]

our facility uses two forms. er and outpatient services both use a form that a nurse or someone similar will complete. if the patient is later admitted, a separate inpatient form must be complete by the physician. if it is a direct admit, admit day of surgery or such, just the inpatient form is completed by the physician.

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[Diary/Dairy, RN]

I cannot believe your ER ever did that to start with.... I have worked a lot of places and the ER did not do the medication reconciliation in any of them.

[luckylucyrn]

We make a med list on the pt, it goes in our computer system that can be pulled up by the floor nurses. It's extremely time consuming but luckily it stays in the system and we can see what the person's meds were last visit and just make changes. I understand the need to do it in the ER, but I hate doing it anyway.

[queenjean]

Our pharmacists try to hit all admits before they come to the floor, to do their med reconcilliation. We'll do it on the floor if the pharmacy doesn't have the time to see them prior to admission, but even then, often the pharmacist will try to see them.

We have a newer computer system, and the pharmacists don't like how the nurses enter stuff in. It is a confusing system, so the general rule is let pharmacy do it and go over their print out unless they haven't been able to see them yet.

[SarahK73]

JACHO standards for med-rec apply for ER patients as well. They have a obligation to ensure they have a complete list of medications, to the best of their ability (just like us on the floor). Our ER has a home medication list that the use on their ER patients. This is signed by the physcian admitting them so it validates them as orders. When we recieve them on the floor we simply review them to be sure they did not forget something or if ER was not able to get it all such as a dosage we then finish it for the physcian to review on first rounds.

ER needs to do their part, we are all busy!