BACKGROUND Medication reconciliation is a safety practice to identify medication order discrepancies when patients' transitions between settings. In nursing homes, registered nurses (RNs) and licensed practical nurses (LPNs), each group with different education preparation and scope of practice responsibilities, perform medication reconciliation. However, little is known about how they differ i...

BACKGROUND Medication reconciliation has been identified as an important intervention to minimize the incidence of unintentional medication discrepancies at transitions in care. However, there is a lack of evidence for the impact of information technology on the rate and incidence of medication discrepancies identified during care transitions. This systematic review was thus, aimed to evaluate ...

BACKGROUND Medication reconciliation in the outpatient setting is an important part of preventing medication errors, and is mandated by the Joint Commission. OBJECTIVE To describe and quantify medication reconciliation efforts by student pharmacists in an outpatient family medicine center. METHODS A retrospective review was conducted of medication reconciliation documentation forms complete...

BACKGROUND Medication discrepancies are common at hospital discharge and can result in adverse events, hospital readmissions, and emergency department visits. Our objectives were to characterize medication discrepancies at hospital discharge and test the effects of a pharmacist intervention on health care utilization following discharge. METHODS We used a prospective, alternating month quasi-...

BACKGROUND The pediatric hospital discharge process presents significant challenges, and medication discrepancies remain an unsolved problem. The purpose of this study was to determine the discrepancy rates at the time of discharge when multiple sources of medication documentation exist, and to characterize the medication discrepancies into error type, medication category, and discharge summary...

BACKGROUND Clear processes to facilitate medication reconciliation in a hospital setting are still undefined. The observation unit allows for a high patient turnover rate, where obtaining accurate medication histories is critical. OBJECTIVES The objective of this study was to assess the ability of pharmacists and student pharmacists to identify discrepancies in medication histories obtained a...

AIMS To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm. METHOD A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children...

BACKGROUND The objective of this study was to investigate whether implementation of multidose drug dispensing (MDD) for elderly outpatients is associated with a change in the number of discrepancies in the medication record at the general practitioners (GPs) and at the community home-care services. METHODS A controlled follow-up study with paired design of patients' medication records was per...

AIM To evaluate the clinical pharmacist-led medication reconciliation process in clinical practice by quantifying and analyzing unintentional medication discrepancies at hospital admission. METHODS An observational prospective study was conducted at the Clinical Department of Internal Medicine, University Hospital Dubrava, during a 1-year period (October 2014 - September 2015) as a part of th...