Risks in medication reconciliation during hospital admission

Abstract

A poster presentation regarding risks in medication reconciliation during hospital admission. Introduction: Medication reconciliation may be defined as "the formal process of checking the full, accurate list of a patient's previous medication and comparing it with the medication prescriptions after a transition of care." After undergoing medication reconciliation, the amount of errors decreases and hence there would be better management of resources due to less readmission of patients to hospital. Since medications usually change on admission, medication reconciliation and pharmacist intervention are relevant criteria to reduce medication errors. Risk assessment plays an important role in prioritising the attention patients require according to the severity of consequences a possible risk might bring. Aims:  To observe the intervention of the pharmacist in patient history-taking and whether the pharmacist is better suited to take medication history than other healthcare professionals.  To carry out medication reconciliation between the medication history obtained by the pharmacist and by the other healthcare professional to identify any changes in the medications patients take.  To analyse clinical significance of discrepancies using risk matrices in order to determine the severity of consequences the patient could have undergone.