Medication reconciliation: implantation process in a hospital complex with the use of electronic system

ABSTRACT

This study evaluated the implementation of medication reconciliation in a philanthropic, teaching, and multi-block hospital with the use of an electronic system to record the multidisciplinary activity. A total of 438 nursing professionals were trained on medication reconciliation. From October 2017 to March 2018, the information about previous use of drugs for 1,379 patients was registered by the nurse in the electronic system. Only 347 of those records were reconciled by the pharmacist, and 106 needed intervention of the prescribing doctor. The number of patients who had the medication prescribed without any change was 180, 47 had the medication prescribed with some change, and 106 did not have the prescribed the medications of previous use. The use of computerized systems can be useful for the teams to perform medication reconciliation, but it depends on the correct use of the system and training of the teams. The daily follow-up of the clinical pharmacist increases patient safety regarding the use of drugs within the hospitals, but to perform the activity some improvement measures are necessary to obtain compliance with the patients’ medication reconciliation in their entirety.

KEYWORDS
Medication reconciliation; Patient safety; Medication errors