Pharmacy–nursing intervention to improve accuracy and completeness of medication histories

Extract

Medication errors are common in hospitalized patients and present a serious threat to patient safety.1,2 The medication reconciliation process, the first step of which is knowing the patient’s current medications, has been identified as key to preventing medication errors.3–6 Obtaining an accurate and complete medication history should be a collaborative effort among patients, family members, nurses, pharmacists, and physicians.

Unfortunately, medication histories are often incomplete or inaccurate,2,6,7 with as many as two thirds containing errors.8 Research supports the need to obtain complete and accurate medication histories on admission.4 The difficulty in the medication reconciliation process may be related to the challenges in obtaining medication histories. These issues are underscored by a February 2009 Joint Commission announcement regarding revised expectations for medication reconciliation.9

Prior research has documented the ability of pharmacists to collect comprehensive and accurate medication histories.7,10 However, there has not been a similar focus on nurses, despite the fact that they often initiate this process.11,12 Because of nurses’ central role in the medication reconciliation process, the task of obtaining a medication history should be integrated into the national standards for nursing competency. To that end, we developed and tested a tool for use by nurses to improve the accuracy and completeness of the medication history.