Nursing or pharmacy responsibility?

[dudette10, MSN, RN]

When I get a new admission, I go through all the home meds and enter when the last dose was taken. After the docs decide to continue each med or not, pharmacy needs to approve before anything can be pulled from the Pyxis to give on admission day.

Some pharmacists will check the last dose date/time and set the next dose as the next day (correct), while others will set the next dose as admission day (incorrect) essentially double-dosing the patient. I talked to one pharmacist who said that it is not her responsibility to check the last dose date/time that I put in because she didn't talk to the patient herself, so she doesn't know if it's true or not. (So she would rather double dose a patient and believe I falsified documentation???)

I have to go through each med scheduled to be given on admission day to determine whether or not to give, based on the patient's last dose and new dosing schedule, if any, put in by the doc. I don't know how many other nurses do this, so I don't know if they are double dosing patients or not.

What at happens with home meds in your facility, and who is responsible for ensuring proper dosing of home meds on admission day?

[SierraBravo]

What at happens with home meds in your facility, and who is responsible for ensuring proper dosing of home meds on admission day?

The provider when they do the admission documentation in the EHR.

[Rose_Queen, BSN, MSN, RN]

We actually have medication reconciliation techs who are responsible for going around and taking medication history- the nurse doesn't have to do it. Seems like since these folks are under the umbrella of pharmacy, it isn't a big issue. Yes, on occasion one slips through, but a quick little note that the med wasn't given because patient took it at home earlier that day is considered sufficient.

[VANurse2010]

Even though medication reconciliation is dumped on nursing in most facilities - it is actually *not* a nursing responsibility - the ultimate legal responsibility for it lies with the provider. Fortunately, where I work (teaching hospital), the med rec. is one of the things that gets pushed to the intern so we have little to no involvement.

[Graduatenurse14]

Upon discharge we have change the next time they need to take a med on their med sheets in their discharge instructions. If I gave Ativan at 8:00 am and it's ordered BID, it always shows the next time the patient should take it is the next day at 8:00 am (I assume since I gave it last at 8 am) so I have to change the date and time. It's a pain!! We use Sunrise and are moving to Epic so I hope that it will be different with that system.