Problem regarding home medication reconciliation


Assignment Task:

Replies 1:

A technology I have only experienced in one facility is in regards to the home medication reconciliation. "Medicines reconciliation, as defined by the Institute for Healthcare Improvement, is the process of identifying an accurate list of a person's current medicines and comparing them with the current list in use, recognising any discrepancies, and documenting any changes, thereby resulting in a complete list of medicines, accurately communicated. (Barnsteiner, 2008). The facility where I'm currently working has an "external database" that shows medications for a patient from a pharmacy that's tells us when meds were last picked up by the patient. So for example, I had a patient that was admitted for AMS and possible CVA at home alone that had her lying on the floor for two days before being found. She was oriented x1 and certainly could not participate in the medication reconciliation portion of the admission process. With this technology I should have been able to view the meds her preferred pharmacy has supplied to her so I could have a better idea of what she takes. The problem is that there was just one medication listed from three years ago.

I think this technology has wonderful potential to help in situations like this but there needs to be more education for both nurses and pharmacists on how it works and keeping the information up to date otherwise it's as untrustworthy as a crumpled up, hand written, undated list of meds found in the bottom of the patients purse. Sure, it can give a vague idea of current meds but it's certainly not reliable information if it's not up to date.

Barnsteiner JH. Medication Reconciliation. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 38.

Replies 2:

Describe a human-technology interface that you have encountered in healthcare that you think needs improving.

The smart pumps are intravenous infusion pumps with software that manages medication administration and prevents drug errors. (Yasser et al., 2021). The pump contains a library of medication set up with a safe dose range and appropriate infusion duration. If the infusion setting is changed outside the pre-configured safety limitations, this program notifies the user by giving a safety alert message for proper dose adjustment. (Yasser et al., 2021). The smart pump can manage secondary infusion. The purpose of secondary administration is to enable the primary continuous infusion to stop during the secondary infusion and then automatically resume when the latter is completed. (Giuliano et al., 2021). Smart pumps are an efficient tool to reduce medication errors and improve patient safety.

Describe what you would specifically like to see changed about this technology and why?

The change I want to see with the pumps is that I wish for the pumps to be able to communicate with the EHR. The pump should include the bar code medication administration and send updates to the EHR with the volume infused to the patient. If those changes were available, we would benefit from time management and documentation regarding medication administration.

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