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Reconcile Discharge Orders with the Nursing Medication Administration Record
2/28/2003 7:41:08 PM
User Comments on Reconcile Discharge Orders with the Nursing Medication Administration Record
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Elizabeth Nolan
Total Posts: 2
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
9/19/2005 3:14:55 PM
A quick perusal of several patients' inpt MAR & their DC meds suggest that it is likely patients will not be DC on every single one of their inpt meds. Thus nurses could be querying every patient case. How are other hospitals handling this?
I read the suggestion about attaching multiple med lists (pre-adm list, inpt list, DC list) but that seems as if it has potential to confuse patients rather than help them. I'd love to see a flowchart of the desired process - and one that has been working well.
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Sabin Sebastian
Total Posts: 1
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
10/21/2005 11:48:13 AM
This is what has been recommended at our hospital for reconciling MAR with DC meds:
When writing discharge meds on the order sheet, use the following titles: Discontinue, Change, Start or Continue. Example is given below:
Medications:
1. Discontinue Folic Acid
2. Change Depakote EC 1500mg a day to Depakote ER 1500mg at bedtime daily [seizures]
3. Start Multivitamin once a day [supplement]
Continue the following:
4. Ambien 10mg daily at bedtime [sleep]
5. Lipitor 10mg daily [cholesterol]
The patient does not see the above order only the medication list on the discharge sheet. This is completed by nursing after reviewing the discharge order and prescriptions-which would then read as follows:
1. Depakote ER 500mg, three tablets at bedtime daily [seizures]
2. Multivitamin once a day [supplement]
3. Ambien 10mg daily at bedtime [sleep]
4. Lipitor 10mg daily [cholesterol]
This way the physicians would quickly[hopefully] learn that they will only be called if the discharge meds differ from the MAR but no title is used to denote that changes are deliberate and not in error.
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Paula Sullivan
Total Posts: 2
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
11/14/2005 9:33:12 AM
Our eye phsicicans do not feel they should have to re order the patients medications that they were on before surgery. They feel this should be up to their primary care phsicians. We have adapted the ambulatory form so that they could just check off to continue or discontinue the medication to make it easier on them. Has anyone else run into problems like this?
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Total Posts: 1
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
1/27/2006 4:50:25 AM
Yes, only it is with the surgeon that we are encountering the problem. They do not feel the medications that do not impact surgical care, i.e., antiphyscotic medications, hypertensive medications, should be up to the primary. The outpatients are left waiting until we can contact the primary care physician, if they have one, to receive their D/C instructions. It is understandable, but frustrating.
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Total Posts: 2
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
7/20/2006 10:28:56 AM
Is anybody trying to give the patient a reconciled admission/discharge list so that they can see side by side what their admission meds were and how they changed to their discharge meds?
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Total Posts: 243
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
7/25/2006 5:25:35 PM
We have heard from hospitals that have done this, as it is important to let patients know what medications should be taken differently when they get home....or not continued at all. Take a look at this form provided to us by Baptist Memorial in Memphis. It serves that purpose
http://www.ihi.org/IHI/Topics/PatientSafety/MedicationSystems/Tools/BMHMemphisMedicationReconciliationForm.htm
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Total Posts: 2
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
7/26/2006 2:45:55 PM
Interesting. Have you evaluated this at all? D.
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Total Posts: 243
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
7/27/2006 12:17:56 PM
I am not sure what you mean by evaluated. The tools we have posted were all either recommended or reviewed by our faculty.
This is just one example. Organizations often need to modify the forms to suit their local environment.
You might want to contact the hospital directly and chat with them.
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Jane Hottinger
Total Posts: 1
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Re: Reconcile Discharge Orders with the Nursing Medication Administration Record
8/14/2006 6:20:18 AM
How does the medication reconciliation affect patients discharged from the ED?
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