Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Med Rec Theory
PP4 Med Rec Theory
| Question | Answer |
|---|---|
| What is the definition of medication reconciliation? | A process for obtaining and documenting a complete and accurate list of a patient’s current medicines upon admission and comparing this list to the prescriber’s admission, transfer and/or discharge orders to identify and resolve discrepancies.’ |
| What actually is med rec? | A formal, systematic process Healthcare professions partner with patients to ensure accurate and complete medication information transfer at interfaces of care Designed to prevent potential medication errors and adverse drug events |
| How can medicines cause patient harm? | 2 – 3% of all hospital ads are med related Up to 30% unplanned geriatric admissions associated with adverse medicines events There are approx 190,000 medication related admissions per year in Australia Estimated cost $660million per year |
| What is the purpose of med rec? | Over half of all hospital medication errors occur at the interfaces of care (admission, transfer and discharge) The process of medication reconciliation can reduce the risk of these medication errors occurring |
| What are some of the things a med rec can pick up? | Unintentional discrepancies (medication left off) Undocumented intentional discrepancies (ceased med with intention to restart at discharge not recorded) |
| What is meant by transitional care? | Refers to the coordination and continuity of health care during a movement from: one healthcare setting to another/home or between HP's as their condition and care needs change during the course of a chronic or acute illness of health care services |
| What is meant by care coordination? | is the organisation of patient care activities between two or more participants (including the patient) involved in a patient's care to facilitate the appropriate delivery |
| What needs to be done with a patients medical record during continuation of care? | Needs to be updated so all pertinent patient medical information is recorded |
| Why are transitions/interfaces of care key targets for improving patient safety? | Prone to errors, over 50% of hospital medication errors occur at admission or transfers. Have the potential to cause patient harm. 22% of discrepancies could have caused patient harm, and 59% of discrepancies could have caused patient after discharge |
| Why should a med rec be performed? | Errors on admission: 10-67% of MX have atleast 1 error 85% of RX errors at transition are carried thrugh to inpatient orders 30-70% of patients have 1+ unintended variation between MX and admission order Patient 65 yrs + 2 x more likely need |
| How does performing a med rec help at discharge? | 12% patients have an error in discharge RX 15% of dcharge meds have discrepancies against chart Readmission 2.3x more likely if 1+ meds omitted from dcharge summary 1 in 2 dcharge sums have atleast 1 med error or discrep |
| How does performing a med rec help with reducing errors and adverse events? | On admission: 50% decrease in no. patients with errors on admission > 50% decrease in no. patients with errors likely to cause possible or probable harm Admission, transfer and discharge: Errors reduced from 213 to 50 per 100 admissions |
| What are the other reasons to perform a med rec? | Reduces workload and repeating of work Cost effective: med rec interventions at admission are cost effective, pharmacist led intvtions has highest net benefits, med rec cost effective use of NHS resources |
| What policies and guideliens does performing a med rec align with? | National Medicines Policy Australian Pharmacy Advisory Council (APAC) Guiding principles 2006 WHO Patient Safety Alliance High 5s initiative WA Pharmaceutical Review Policy SHPA Standards for Clinical Pharmacy |
| What is pharmaceutical review? | the systematic appraisal of all aspects of a patient’s medication management to optimise patient outcomes. |
| What are the 5 standards of the WA Pharmaceutical review policy? | 1. Chart Review 2. Med rec on admission 3. Medication education during hospital stay and discharge 4. Discharge process: communication with general practitioners and other HP's 5. Quality initatives promoting medication safety. |
| The ACSQHC and the WA Pharmaceutical Review Policy defines a High-Risk Patient as: a patient who meets one or more of the following criteria: | Take 5+ regular meds Taking 12+ doses of meds a day Significant change made to med treatment in last 3 months med with narrow TI/requires TDM (APINCH) Symptoms of an ADR Suboptimal response to med treatment Non-compliance/can't manage |
| Further high risk criteria: | Can't manage due to literacy/language barriers, dexterity, impaired sight, confusion, other cognitive difficulties patients with a number of doctors (GP's + Specialists) Recently discharged from facility in last 4 weeks |
| What are the steps to performing a med rec? | 1. Obtain BPMH - formal interview process 2. Confirm the accuracy of the history - confirm with patient and second source 3. Reconcile the BPMH with prescribed meds on admission and discharge/transfer 4, Supply accurate medicines information to all inv |
| Why is taking a BPHM important? | Ensuring continuity of medication management Identifying medicine related problems contributing to admission Identifying potential medication related discrepancies Informing decision making process Optimising the use of medicines |
| How can med recs be performed? | Proactively: seen prior to admission Retroactively: PAtient admitted to ward, medicines prescribed on chart, med rec performed after |
| What resources can be used to gather patient information before conducting med rec? | Inpatient notes (age, language barrier, cognitive impairment, place of residence, medication list) Headhseet (old notes, previous admission) Isoft clinical manager Bedside notes (charts) Patients on Medicines |
| List patients who are not appropriate to interview for med rec | Cognitive impairment, residential care patient, children, critically or terminally ill |
| What is the WA MMP? | Designed to meet WA and Aus med rec requirements. Designed to record medicines taken prior to hospital, recording patients meds on admission, intra-inter hospital transfer and at discharge |
| How should the strength of the medication be recorded? | Metoprolol 50mg BD Dexamethasone 8mg mane (2 x 4mg tablets) If a patient is on digoxin 125microgram in the morning, the strength of the tablet used by the patient should be included and recorded as “62.5microg x 2 mane” or “HALF x 250microg mane” |
Created by:
LDM
Popular Pharmacology sets