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Hi All,
I was asked to post this to the L. Here ar e the ways people are doing
med reconciliation:
IATRICS PDI
We currently have the nurses document home meds on a Nursing Admission
Assessment in Meditech. This information pulls over to the Iatrics PDI
program. The nurses at that point print out for the doctors a list of
the patients current home meds for the doctor to decide which meds to
continue or dc while in the hospital.
On Transfer, in the Iatrics program they print out a transfer profile,
which includes all of the patients current in house meds, along with the
patients home meds. Once again, this is for the doctor to indicate what
to continue or dc upon transfer.
At discharge, the nurse prints out a discharge medications profile out
of iatrics for the Physician to use to write discharge medications and
to reconcile, which includes the current meds at that point along with
home meds again.
IATRICS NPR REPORTS
Iatric Systems did this for us. Here's our process:
Nurse documents med/allergy assessment. Pharmacy enters admission
orders. Nursing prints the Admission med recon report. The Pharmacy
meds are listed in bold. If there's a matching home med (linked by
generic in the background) it prints under the pharmacy med in regular
print, separated by a dotted line. The meds are listed in class order.
The dr marks whether or not to continue in the hospital.
On discharge, another report is printed & the dr marks whether or not to
continue at home. Then, the nurse documents the med/allergy assessment
with the meds the pt is to go home on. The home meds list is then
printed. It lists frequency & purpose in layman's language.
It seems to be working pretty well for us. It requires some extra work
on the nurses' side, but they all realize this will be better for the
pt.
COMBINATION OF CDS AND NPR REPORTS
We are implementing a new process that is similar to what you describe
below. There is a CDS in Nursing the staff fills out the home medications by
doing an intervention.
There was an NPR report that we downloaded which had the patient's current
medications from pharmacy. I changed the report and wrote a fragment to go
into Nursing and grab the CDS and put it onto the current med form. We are
planning on using it for transfer and discharge of patients. Everything
prints out together. I added some yes/no check boxes by the meds for the
physician to check off and some signature lines at the bottom for the
physician to sign and the nurse to sign.
MEDITECH 5.6
Supposedly in 5.6 Meditech has created something in PCM. I asked for
information on this and I am waiting to hear back.
-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED] On Behalf Of Tara Mcnamara
Sent: Wednesday, August 09, 2006 8:16 AM
To: Meditech L
Subject: [MEDITECH-L] Med reconciliation
All messages should be posted in plain text. HTML will be converted to
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======================================
Hi All,
I know this has been a big topic on the L. I thought I had it all
figured out thanks to all of your suggestions. Here is what I set up
Nursing to do::
1. Home med assessment screen for nurses to document and have it print
down in pharmacy if complete via the OA message attribute 2. On
discharge, we currently print their current list and the physician
circles yes or no to continue 3. The Nurse is currently re-writing the
discharge list so it is more patient friendly and then add instructions.
Have an assessment that will pull in the current meds from pharmacy and
allow for edits to be made-this prints making a nice patient friendly
version. It allows the nurse to add on meds that the patient is on at
home, but may not be on their current profile.
I thought this would work until I attended their med meeting this
morning.
Here is what they want
1. They want to have nursing type in the home med list on the assessment
(so they liked number 1) 2. On discharge, they want an assessment for
the physician to answer on line a yes or no to continue and have it list
the current profile and the home med list together and just print a nice
patient friendly copy of the meds they said yes to.
-I feel like this is next to impossible. Has anyone hired Iatrics or
other companies to handle a complex report for med reconcillation or
would you be kind enough to share if you have something like this? Our
docs are actually open to documenting on line.
Thanks!
Tara McNamara MT (ASCP)
Meditech Analyst
Rehabilitation Hospital of the Cape and Islands
Ph: 508-833-4025
Fx: 508-833-4056
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