Medicines reconciliation Flashcards
1
Q
What is medicine reconciliation?
A
- The process of obtaining an up to date and accurate medication list
2
Q
When should med rec happen?
A
- Transferring between different settings
- Hospital discharge
3
Q
Importance of med rec
A
- Reduce risk of medication errors and adverse effects
- Ensures continuity of treatment
- Provides best care
- Reduces waste
- Efficient use of time
- Improves patient involvement
4
Q
How to carry out a medication reconciliation (3 C’s)
A
- Collect: info about patients med including DH
- Checking: that the info is accurate by comparing to other sources (minimum of two resources)
- Communicating: with patient and members of the MDT
5
Q
How to take a drug history (DHx) step 1
A
- Before seeing patient
- Check PMH, PC, possible diagnosis and SCR
6
Q
How to take a drug history (DHx) step 2
A
- Starting the convo
- Introduce yourself — smile, eye contact, state your name and role, and ask ‘Is
it OK to talk about your medicines?’ - Explain to the patient and/or their carer why the history is being taken
- Use a balance of open-ended questions (e.g., what, how, why, when) with
closed questions (i.e., those requiring yes/no answers) - Structure the conversation around their medication or a GP list if available
- Avoid jargon — keep it simple
- Clarify vague responses with further questioning or by using other sources of
information
7
Q
Taking drug history step 3
A
- What medicines should you enquire about?
- All regular and when required med?
- Recently stopped or changed medication? Antibiotics?
- Allergies?
- Different formulations
- Smoking, alcohol, recreational drugs?
- OTC, herbal or online remedies?
8
Q
Drug history step 5
A
- Who looks after your medicines at home?
*Do you have any difficulties taking your medicines? - Are they in separate boxes or one big pack? e.g., multi-compartment compliance
aids (MCAs) or original containers - Have there been any recent changes to your medicines or any recent hospital
admission? - Do you have any of your own medicines with you? Do you have any in your locker?
- Do you have any at home? Do you know how much you have left at home? (for
discharge) - Do you get medicines from anywhere other than the GP? e.g., home delivery,
hospital, chemo (refer), clinical trial, MCAs.
9
Q
Drug history 6
A
- Generic name of the drug
- Strength
- Dose
- Frequency - if its specific days which days?
- Formulation
- Route of administration
- Device and brand for injectables
10
Q
Drug history step 8
A
- Patient or patients representative
- Patients medicines
- Patients medical records
- Patients GP
- Care home records
- RP
11
Q
High risk medication and conditions
A
12
Q
Why are anticoagulants high risk and name some examples
A
13
Q
MAR chart
A
- Source used for DH
- Medicine administration record
14
Q
Difference between DHx and med rec
A
- Medicine reconciliation is a multi step process
- Drug history is one step of the med rec process
15
Q
Checklist
A
16
Q
Patients own drugs POD
A
- This is also another source used for DH
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