Patient Flow / Medication Reconcilliation

Tweety, BSN, RN · Sep 6, 2006

Welcome. I moved the thread out of Introductions to the General section since your are asking specific questions. Hopefully someone will read it and help you out. Good luck!

MQ Edna · Sep 6, 2006

I'm not in managment and therefore cannot answer your questions regarding "patient flow indicators" and "surveyor suggestions". But I can tell you how we do the med. reconciliation in the hospital where I work.

The med. reconciliation is part of the computerized patient admission information. We (as nurses) are to provide the source of the information (patient, relative, chart, other) and the name/phone number of the patient's pharmacy. Then comes the tedious chore of typing in all the medications (including herbals and otc). Name, dose, route and frequency, one by one. There is an alphabetical list of pharmacy formulary meds., if any meds cannot be found under the list they are listed as "non-formulary".

This is the responsibility of the admitting nurse. If the med-reconciliation is not done by the admitting nurse than the next nurse down the line is responsible and so on. I was once forced to dig up info and complete the med. reconciliation on a patient that had been admitted 3 days prior. The oncoming nurse informed me that she wasn't going to "clean that up" and that is was my responsibility to complete the med. reconciliation. I learned my lesson from that! Now, I insist that the admitting nurse finish the med. reconciliation if it isn't completed when I come on (I do this in a nice way . . .of course!). Sometimes, the admitting nurse is unable to do the med. reconciliation because the patient is incoherant, did not come in with family/friends and there is no record of meds. in the chart. I will do what I can to help out and get info in that sort of a case.

bbbbbbbb · Sep 7, 2006

Thank you, let me know if I can ever help you.

veegeern, BSN, RN · Sep 8, 2006

Are you just referring to reconciliation at admission, or reconciliation b/t units also?

bbbbbbbb · Sep 12, 2006

Admission to community practices.

deanaRN · Sep 12, 2006

My hosp does med rec 3 times. Once on admission, again if there is any transfer (to/from surgery or to/from another floor) and then the 3rd at discharge. We must include as part of discharge teaching.

Sterling'sAunt · Aug 19, 2008

I am also interested in the same information. We concentrate on patient flow and "pull the cord" when a patient is waiting for a bed but we don't have indicators to truly reflect what is going on in house. I feel we should have that as well.

We do med rec on admission, transfer and discharge and also at post op. We consider that a transfer from one level of care to another. I do not hear others considering this area as one that would require med rec and wonder if we require this unnecessarily.

Please share not only your patient flow indicators but also "do you have a position in nursing considered patient flow coordinators". This is different than discharge planners, different than case managers. I see this person as the nurse who knows Mrs Brown will be discharged on Wed and still needs education re: new diabetes, needs to see a social worker for assistance with medications, needs pt for crutch walking, needs dcp as well. Does anyone have this? Another even more important scenerio for this person is: the physician said Mrs. Brown can go home tomorrow if the xyz result comes back normal. You look today and see it is normal so you call the physician today and get the patient discharged today. Hours saved is another patients ability to get care in that bed.

Anyone out there doing this? Thank you.