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Description of a Pharmacy Technician and Student Intern-Driven Medication Reconciliation Process and Evaluation of Medical Provider Acceptance of Recommendations to Reorder Critical Medications(The University of Arizona., 2011)OBJECTIVES: To describe a pharmacy technician and student intern-driven medication reconciliation process and to evaluate medical provider acceptance of recommendations to reorder critical medications. METHODS: Patients admitted to Northwest Medical Center had medication histories taken on admission. A specially trained pharmacy technician or student intern reviewed these histories, with emphasis placed on critical medications as defined by the Pharmacy and Therapeutics Committee. Recommendations to re-order these critical medications were made to medical providers. All patients, excluding those under 18 years of age or current enrollment in the prison system, admitted during the months of May-June 2010 were reviewed for acceptance of critical medication recommendations through information recorded in the pharmacy electronic medical record system. RESULTS: One hundred seventy-eight (178) recommendations were made on 132 patients requiring recommendations. All medical providers accepted 102 (57%, p-value=0.008) of the recommendations made. Hospitalists were more likely than physician specialists or surgeons to accept recommendations made (62.5%, p-value<0.001). Recommendations made regarding thyroid products were accepted the greatest majority of the time (82.1%, p-value<0.001); antidepressants (54.8%, p-value=0.321), anticonvulsants (63.2%, p-value=0.194), and medications classified as other (55.6%, p-value=0.480) were also accepted a majority of the time. Vitamin K antagonists did not have recommendations accepted a majority of the time (31.8%, p-value=0.034). CONCLUSION: Medical providers accepted a majority of recommendations to reorder critical medications made by pharmacy technicians or student interns.
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Medication Reconciliation at an Academic Medical Center: Perceptions from Medical Professionals(The University of Arizona., 2012)Specific Aims: The goal of this project was to assess perceptions of medication reconciliation from medical professionals who perform them. Specific areas of interest included the perceived: amount of time spent on medication reconciliation; process complexity; and effectiveness of the current process. Opinions concerning the use of alternative processes were also solicited. Methods: This prospective qualitative study involved four focus group sessions at one tertiary referral teaching hospital in Tucson, Arizona. Nurses involved in admissions medication reconciliation in the emergency department were invited to participate, and their perceptions were categorized and summarized. Main Results: Participants reported a range of times to complete the medication reconciliation from zero to greater than 20 minutes. According to the participants, the time spent on each patient depended on patients’ medication knowledge and the complexity of their regimens. Participants wanted the medication list entry screen to be easier to use, and they also suggested patients’ medication lists from previous visits and from outpatient clinics associated with the medical center be easily accessible. Participants felt that emergency triage may not be the most ideal time in which to perform medication reconciliation, and they expressed concerns about accuracy of these medication lists. While some were interested in the possibility of using a patient medication database and expected that it would improve accuracy and save time, others were less open to a perceived additional step. Concusions: Participants provided suggestions for changes in the current medication reconciliation process that they feel could improve patient satisfaction and increase efficiency.
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The role of family participation in a medication information program on schizophrenic clients' medication behaviors: a replication(The University of Arizona., 1992)
