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If a patient comes through ER and is admitted, ER gathers the information
and enters it on the Med Reconciliation (it is set up in NUR as an
assessment), then they fax it from Meditech to the primary care physician or
attending physician if the primary care is out of town. That is ideally how
it works. ER doesn't fee they need to gather the info and enter it on the
Med Reconciliation. If the patient is a direct admit, nursing gathers the
info and faxes it to the physician. If it is after hours or on a weekend
(during daylight hours) the nurse calls the physician to see what meds they
want continued or dc'd. If the patient/family doesn't know, nursing calls
the patient's pharmacy (gets a little complicated when they do mail order
meds from AARP, or Canadian meds, or from the VA). Once we have the
physician's signature and meds marked the nurses fax it to pharmacy. Our
pharmacy enters the orders, calls for verification, acts in an advisory
person for Med Reconciliation. Some of our docs still don't get it, don't
want to get it, or just write the meds out on a physician order themselves.
Our biggest problems so far have been the patients that tell you a few hours
later the meds they forgot to mention before, or that they really don't take
the med anymore. Nursing is having a hard time deciding on how to handle
those changes, especially after the form has been signed by the physician.
Charlotte Snider RN
Clinical Coordinator I/T
Therapy is expensive.
Poppin' bubble wrap is cheap.
The choice is yours!!
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From: "HEATHER HENRY" <[EMAIL PROTECTED]>
To: [EMAIL PROTECTED]
Subject: FW: [MEDITECH-L] Medication Reconciliation Process
Date: Tue, 04 Apr 2006 08:31:37 -0500
From: "Castillo, Cristina" <[EMAIL PROTECTED]>
To: <[email protected]>, <[EMAIL PROTECTED]>
Subject: [MEDITECH-L] Medication Reconciliation Process
Date: Mon, 3 Apr 2006 12:11:42 -0700
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Our Pharmacy and Nursing are kinda having a struggle on who should do
what. Currently, this is our process which we just implemented:
1. Nursing collects the Home Meds list during the admission process.
They also ask for the Pharmacy name and phone number.
2. The list gets printed thru a standard profile format report.
3. The report is shown to the physician where they can indicate whether
it is a DC or Continue.
4. It is then faxed to pharmacy to enter it in the system.
No Problem here.
Now, when nursing can't obtain the medication list either from patient
or family but somehow has the name of the pharmacy and the phone, they
feel that Pharmacy has to call the outside pharmacy, obtain the list
then enter it thru an NUR CDS. A trigger query will print an instruction
to the nursing unit to print the profile, then nursing does Step 3 and 4
as above. Pharmacy feels that Nursing should be calling the outside
Pharmacy and obtain the list themselves.
How much involvement does your Pharmacy have in the Medication
Reconciliation process? How does it work in your facility and would you
mind sharing your process? Thanks in advance!
Cristina G. Castillo, BSN, RN
Manager, Clinical Informatics
Pacific Alliance Medical Center
531 W. College St.
Los Angeles, Ca 90012
Ph: (213) 437-4214
Fax: (213) 617-9203
Email: [EMAIL PROTECTED]
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