Transcript Introduction PowerPoint

DISTRICT
MEDICATION
RECONCILIATION
AND
ADMINISTRATION
Adapted from Medication Reconciliation from the
QSEN website
Originally developed by
Judy Young, RN, MS Lecturer
Indiana University School of Nursing
[email protected]
Purpose of the learning activity
 The purpose of this learning activity is to enhance your
understanding of medication reconciliation as a quality
improvement measure to enhance patient safety and prepare
you to perform medication reconciliation on a client in the
clinical setting. Moreover, this activity will give you an
opportunity to practice the six rights and three checks of
medication administration to a group of clients.
 This learning activity uses five simulated clients who require
medication administration using the electronic medication cart.
 Prior to performing district medication administration in the
nursing lab for these clients, you will review the standards for
medication reconciliation and apply your clinical reasoning skills
to identify .
Review of medication reconciliation
 What is medication reconciliation?
 The process of identifying the most accurate list of all medications
that the patient is taking, including name, dosage, frequency, and
route, by comparing the medical record to an external list of
medications obtained from a patient, hospital, or other provider.
 Why is it so important?
 To prevent numerous prescribing and administration errors.
 Which Joint Commission NPSG does it meet?
 Medication Safety: Goal 3:
 Improve the safety of using medications
 What EHR certification criteria does it meet?
 Clinical Information reconciliation

2014 Edition EHR certification criteria focuses on the reconciliation of
data in each of a patient’s medication, problem, and medication allergy
lists.
Difference between clinical information
and medication reconciliation
 Certified Electronic Health Records (EHR) will
perform clinical information reconciliation:
 Requires providers to reconcile the problem list and
medication allergy lists in addition to the medication
list in medication reconciliation
Steps for medication reconciliation
are developed by the agency
SCCC steps for this exercise:
1. Develop a list of current medications, herbal supplements,
OTC drugs, vitamin and minerals from home prior to
admission;
2. Develop a list of medications to be prescribed during
admission
3. Determine if prescribed medications are within the standard
of care for the client’s problem
4. Compare the medications on the two lists
5. Make clinical decisions based on the comparison

6.
Seek clarification with health care providers as to what
medications should continue, hold or discontinue
Create a comprehensive list to communicate to appropriate
caregivers and to the patient.
Gather Materials
You will need:
 Internet access to view patient chart information
 a reconciliation form for each assigned patient
 See next slide for completion instructions
 A current drug guide or electronic access to Daily Med
Review of reconciliation form
1.
2.
3.
4.
5.
Enter sources; pt, family, records as appropriate
Print medication information in space provided
Indicated when medication was last taken
Circle “c” if continued on admission or “DC” if discontinued
Place a check in the box for “Drug clarification required” if the review of client
information; clinical status, labs, condition indicate that you need to talk with the
prescribing physician
6. Place a check in the box for “Dose clarification required” if the review of client’s
medication dose is inconsistent with standard of care, clinical condition or previously
prescribed amount. Explain rationale in section labeled: “clarification/concern” for
patient list, orders and MAR in the Medication Reconciliation worksheet
Let’s begin….
You are the nurse assigned to an acute care medical surgical
unit. The EHR system was down for the past three days
due to system-wide disruption.
The hospital was using a backup paper record system during
the failure. While records are starting to be added to the
EHR, it will require additional time. The Computer
physician order entry (CPOE) has been restored and the
electronic medication cart is in use. Due to the disruption
in the EHR, standard physician order sets were not
employed, so physician orders need to be reconciled with
the standard order sets as well.
You have been assigned district medications for four
patients. Let’s meet your patients…