Patient care must include recurrent assessment of medication regimens
Medication reconciliation is a complex and cooperative clinical task required of physicians, nurses and pharmacists in which the goal is to minimize discrepancies and inappropriate medication orders. This safety practice, which reduces the likelihood of adverse drug effects, involves reviews of patients’ medications during transitions between care settings.
To increase implementation of this practice in healthcare institutions such as hospitals and nursing homes, a gerontologic nursing expert suggests acknowledging practitioners’ varying perspectives on the purpose of medication reconciliation and each practitioner’s role.
This higher-level thinking process involves studying a patient’s entire therapeutic plan. However, assistant professor at the University of Missouri Sinclair School of Nursing, Amy Vogelsmeier, and researchers from the Salt Lake City Veterans Affairs Medical Center and the University of Utah discovered that healthcare professionals often perceived medication reconciliation as a “checklist” task.
“Medication reconciliation is more than just matching medication lists when patients transition among hospitals, personal residences, nursing homes and other healthcare settings,” Vogelsmeier said. “It’s an opportunity to ask whether medications are still appropriate and consistent with the patients’ therapeutic goals and then to make adjustments to their medication regimens if needed. The constant surveillance of medications is critical because adverse drug events happen when people are taking medications they no longer need or aren’t taking medications they need.”
After analyzing data gathered from focus groups with physicians, nurses, and pharmacists at 3 US Department of Veterans Affairs Health Administration hospitals, Vogelsmeier determined that professionals in the 3 disciplines identified their roles in medication reconciliation differently.
“Medication reconciliation doesn’t fall to one discipline; it’s a joint effort,” she said. “Physicians are ultimately accountable for assuring patients’ medication therapy is appropriate, but pharmacists play critical roles because of their in-depth knowledge of medication management and their focus on medication safety. Nurses are the ones who identify and communicate what patients are really taking at home because of their proximity to patients and their families when they transition to healthcare settings.”
To improve the process, Vogelsmeier suggests that computerized information systems be designed to integrate input from each health practitioner role into the medication reconciliation process. Then, practitioners can provide up-to-date information and ensure accuracy of records.
Source: University of Missouri.