Breakdowns in the medication reconciliation process
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Pennsylvania patient safety advisory
- Author(s):
- Gao, Tingting, author Gaunt, Michael J., author
- Contributor(s):
- Pennsylvania. Patient Safety Authority, issuing body. ECRI (Organization), issuing body. Institute for Safe Medication Practices, issuing body.
- Publication:
- [Harrisburg, Pa.] : Pennsylvania Patient Safety Authority, [2013]
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Medication Errors -- prevention & control Medication Reconciliation Drug Prescriptions Medical History Taking Medication Reconciliation -- methods Medication Therapy Management Prescription Drugs -- administration & dosage Process Assessment (Health Care) Humans Pennsylvania United States
- Genre(s):
- Technical Report
- Abstract:
- Pennsylvania Patient Safety Authority analysts identified 501 reports involving breakdowns in the medication reconciliation process with event dates between November 1, 2011, and November 31, 2012. Analysts reviewed these reports to classify the events by type of reconciliation, event type, and possible causes and contributing factors. The majority of events occurred during admission medication reconciliation (69.3%, n = 347). Events most often originated during prescribing (40.3%, n = 202) and transcribing (26.9%, n = 135). Drug omission was the most frequently reported (26.7%, n = 134) event type overall. Other top event types included wrong dose and additional drug or dose. Important risk reduction strategies include standardizing processes, clearly defining the roles and responsibilities of staff involved in the medication reconciliation process, using a standardized medication reconciliation form with a scripted list of questions or prompts, and engaging patients when obtaining their history and determining treatment.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (13 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 101622361 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/101622361