Medicine reconciliation Flashcards
What is a Medication error
A failure in the treatment process that leads to, or has the potential to lead to,
harm to the patient
How long does it take inpatients in acute setting to have a reconciled list of their medicines
Within 24 hours of admission
What is medicine Reconciliation
The process of identifying the most accurate list of patients current medication and comparing them to the current list in use, recognising any discrepancies and documents any changes thus resulting in a complete list of medications
What is medication review
A structure, critical examination of a patient’s medicines with the objective of reaching an agreement with the patient about treatment, optimising the impact of medicines, minimising the number of medication related problems and reducing waste
5 steps in carrying out medicine reconciliation
Develop a list of current medications
Develop a list of medications to be prescribed
Compare the medications on the two lists
Make clinical decisions based on the comparison
Communicate the new list to appropriate caregivers and to the patient
What are the 3 C’s of medicine reconciliation
Collecting
Checking
Communicating
Benefits of medicine reconciliation
Better communication between healthcare professionals Reduced waste of time and money Reduced errors and adverse events Foundation for optimising medicines Check effectiveness Better and safer patient experience Identify drug related admissions Discharge issues opportunity for advice and counselling
What does medication history encompass
checking on allergies and sensitivities to previously prescribed medication
Documenting all regular and occasional prescribed and non prescribed medications
Side effects to current and past medications
Information on how the patient manages their medicines at home
What details of the medication do you need to record
Name Strength Dosage Formulation Frequency of administration Route of administration
Key components of history taking
Medicine’s obtained on prescription from a previous prescriber
Medicines purchased over the counter or via the internet
Recreational drug use
Medicines to which the patient has a significant intolerance or true allergy
Explain the advantages and pitfalls of referral letters
Advantages - Provides brief details of recent medication. May provide details of medication for both acute and chronic disease. Often include allergy status
Pitfalls - often lacks full details needed to prescribe. Unclear which medicines remain current. May be generated by a prescriber less familiar with the patient
Advantages and pitfalls of repeat prescriptions
Advantages - Usually provides full details needed for prescribing. May give information regarding adherence
Pitfalls - may be out-of-date. Patient may carry multiple copies. Verbally agreed and recent changes may not appear
Advantages and pitfalls of Hospital discharge letter
Advantages - provides details of medication for both acute and chronic disease
Pitfalls - ma be difficult to read if handwritten. Full prescribing details may be lacking. May not be recent enough. less useful in Patients those condition is unstable
