Slide 10

Medication Reconciliation

• Hospital procedure for completing medication reconciliation at discharge
• DA may participate and conduct final check on medications
• Using final list, populate Patient Care Plan and complete additional columns (e.g., purpose, time of day)
• Final list used to instruct the patient

Notes:

Your process for conducting medication reconciliation at discharge likely involves the physician, nurse and, perhaps, the pharmacist. An important aspect of medication reconciliation at discharge is using the actual list of prescribed medications to instruct the patient. Reconcile the list with the patient and family by talking to them about the listed medications and other medications that the patient may think are safe to take at home.