Medicines Reconcilliation Flashcards
What is medicines reconciliation?
- The process of obtaining an accurately list of up to date medication list that has been compared to most recently available information
- Documents any:
- discrepancies
- changes
- deletions
- additions
When should medicines reconciliation happen?
- Transfer of care between different settings 2. Hospital admission (planned and emergency) 3. Hospital discharge or entry into residential or nursing care
Why do medicines reconciliation?
- Reduces number of prescribing errors 2. Reduce hospital admissions and re-admissions due to harm to medicine 3. Reduces the number of missed doses 4. Improves the quality and timeliness of information which leads to improved therapeutic outcomes 5. Increased patient involvement in own care promotes better concordance 6. Reduces waste
What are the 3C’s of medicine reconciliation?
- Collecting 2. Checking 3. Communicating
Describe what the collecting step requires?
- The most recent patient medication history is taken with the date written down 2. Analysing the patient medication record and speaking to the patient to identify any new information to add 3.
Describe what the checking step requires?
- Comparing of information gathered from different sources from one another 2. Ensuring that the drug, dose and the strength match each other 3. A recording of what the patient is currently prescribed and what they are taking should be recorded too
Describe what the communicating step requires?
- Making changes to the patient record or prescription 2. Communicating this to the patient and the health care team
What are the steps to gather information?
The usual steps that are taken for a responding to symptoms or new medicine consolation 1. Confirm patients name and DOB/address 2. Explain what you are going to do (with consent) 3. Ask if they have bought your medication or list of medications in 4. How they take each item 5. Any other medication 6. Medicines from pharmacy OTC, shop or internet 7. Any herbal medicines, vitamins and supplements/homeopathic, recreational drugs or smoking 8. Recent changes to medication
What are the different sources of information can you use to get the patients medications?
- Ask patient 2. Patient’s own drugs (POD) 3. Repeat prescriptions 4. Relatives and carers 5. GP letter and surgery 6. Reminder chart and devices 7. Discharge summary 8. Care home records
What are reliable information sources that you can use to gather history of the patients medication?
- Computer print out: GP system 2. Patients repeat prescription request 3. Verbal information from family or carers 4. Medical notes from a patients admission previously to the hospital 5. Patients own drugs (POGS)
What must be recorded for each medication?
- Name 2. Dose 3. Strength 4. Form 5. Duration 6. Indication 7. Problems
What must be checked on a POD
- Patient own drugs must have label checked 2. Consent to use and destroy 3. How much at home 4. How many on repeat 5. How managed at home
What is the NPSA green bags?
Given when the patient leaves the hospital which contains all the drugs they’ve been given
What are the kinds of medicines you need to watch out for during a medicines reconciliation?
- Warfarin 2. NOACs 3. Steroids 4. OCP/HRT 5. Methotrexate 6. Bisphosphonates 7. Insulin 8. Inhalers 9. Anti-biotics
What are the kinds of conditions you need to watch out for during a medicines reconciliation?
- Drug misusers 2. Parkinson 3. Epilepsy 4. Chemotherapy