Medication Reconcilliation

~Mi Vida Loca~RN, ASN, RN · May 31, 2017

On the floors I work, when a pt is being admitted, the home medications are to be reviewed in the ED by a med tech and then reviewed again my the RN as part of the admission process. Is this the most common method? We seem to run into a lot of problems where the first med rec is not done or not done correctly. Also, if the patient has a list, they too often send it home with family because they think it is no longer needed. Meanwhile, the doctors may be writing orders based on this information which may or may not be correct. It makes us floor nurses crazy.
Another question I have is that if a patient comes in for a scheduled surgery that morning, we are still expected to verify their home medications when they come to the floor as a post op. I can't imagine how a post op patient, who is feeling pretty lousy and full of pain medication, is able to give a reliable account of medications they take at home. Is this common practice? It makes no sense to me.

I absolutely loathe doing med recs. 3 of the hospitals I worked at had Pharmacy techs that did them and it was glorious and I loved them!

Sour Lemon · May 31, 2017

On the floors I work, when a pt is being admitted, the home medications are to be reviewed in the ED by a med tech and then reviewed again my the RN as part of the admission process. Is this the most common method? We seem to run into a lot of problems where the first med rec is not done or not done correctly. Also, if the patient has a list, they too often send it home with family because they think it is no longer needed. Meanwhile, the doctors may be writing orders based on this information which may or may not be correct. It makes us floor nurses crazy.
Another question I have is that if a patient comes in for a scheduled surgery that morning, we are still expected to verify their home medications when they come to the floor as a post op. I can't imagine how a post op patient, who is feeling pretty lousy and full of pain medication, is able to give a reliable account of medications they take at home. Is this common practice? It makes no sense to me.

I've only worked at three hospitals, but the floor nurse was responsible for the accuracy of the med rec on all three. Sometimes the ED starts it or "reviews" it, but rarely is it exactly correct. It's usually reflective of what they were taking the last time they were admitted.

~Mi Vida Loca~RN, ASN, RN · Jun 1, 2017

I've only worked at three hospitals, but the floor nurse was responsible for the accuracy of the med rec on all three. Sometimes the ED starts it or "reviews" it, but rarely is it exactly correct. It's usually reflective of what they were taking the last time they were admitted.

Yea I would never go off a ER nurses med rec as being accurate. There might be a few that always take the time to ensure it is all done properly and good. But I would be willing to bet it's definitely not the majority. Even when we are "supposed to" I mean really it's better for them to have the pharm techs do it anyway. It can be very tedious and time consuming and rarely do we have that kind of time. The pharmacy techs are thorough and even call pharmacies to verify. I really think facilities need to get on board with this.