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academies
Archives of General Internal Medicine | Volume 2
&
April 04-05, 2018 | Miami, USA
International Conference on
Internal Medicine & Practice and Primary Care
International Meeting on
Breast Pathology & Cancer Diagnosis
Introduction
: Medication reconciliation is the process of
creating the most accurate list possible of all medications a
patient is taking —including drug name, dosage, frequency,
and route— and comparing that list against the physician’s
admission, transfer, and/or discharge orders, with the
goal of providing correct medications to the patient at all
transition. The average hospitalized patient is subject to at
least one medication error per day. More than 40 percent
of medication errors are believed to result from inadequate
reconciliation in handoffs during admission, transfer, and
discharge of patients. Of these errors, about 20 percent are
believed to result in harm. Many of these errors would be
averted if medication reconciliation processes were in place.
Methods
: During the project period which extended from
September to October 2017, 106 patient charts were
reviewed. Fifty patient charts were reviewed during pre-
intervention period and 56 patient charts were reviewed
during intervention period. Preintervention period was
until September 18 and intervention period started after
that. Only the patient admitted to two floors 6NW and 7M
with eight or more medication were included. Medication
reconciliation done during the admission and discharge
were reviewed. Then intervention was done by educating
residents and nurses about the project and differed ways
available for doing the medication reconciliation. The charts
of the patient admitted after my interventions were also
reviewed for medication reconciliation error.
Results
: Of the 50-patients enrolled in pre-intervention
period 35 patient had incomplete medication reconciliation.
Discrepancies were present on 30 patient’s medication
reconciliations. Most of the discrepancies were for dosing.
Other discrepancies included duplicate medication, old
medication not removed and important medication not
resumed during admission. During post intervention of
56 patients, 18 patient’s chart had incomplete medication
reconciliation and discrepancies were present on 8 patient’s
charts.
Conclusion
: Error and discrepancy do occur during
medication reconciliation. Mostly occurs during transfer to
floor from ICU or ER and on those patients who has multiple
medications. Other discrepancies occur during admission
from nursing home or discharge to the nursing home. It is
impossible to eliminate medication reconciliation error, but
some steps can be taken to reduce it. Change in EMR to be
more user friendly, educating staff, patient and relatives and
an appointment of medication historian whose job will be
medication reconciliation of the patient who comes to the
hospital.
Speaker Biography
Asish Regmi completed his medical school from Kathmandu medical college in the year
2017.after that he started working as medical officer in Kathmandu region for almost 4
years. Then he came to USA for his residency in the 2016 and is now 2nd year medical
resident in Guthrie/ Robert Packer hospital.
e:
asish.regmi@guthrie.orgImproving medication reconciliation in Robert Packer Hospital: A quality improvement project
Asish Regmi
Guthrie Robert Packer Hospital, USA