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Risk Management Issue Essay

1536 words - 6 pages

Risk management is described as "a program directed toward identifying, evaluating, and taking corrective action against potential risks that could lead to injury" (Shannon & Decker, 2009).Medication errors remain one of the most frequent problems that put patients at risk in healthcare (Joint Commission, 2009). In 2005 The Joint Commission issued The National Patient Safety Goals of which medication reconciliation is one of the mandatory requirements for recertification. Since this goal was instituted many organizations have continued to struggle with development and implementation of effective processes to meet the goal.This paper will explore how Iowa Health Des Moines addressed the medication reconciliation process. It will demonstrate some of the specific actions taken by selected nursing units in the facility to promote medication reconciliation. It will also show some other solutions by other facilities in addressing this National Safety Goal.Medication Reconciliation at Iowa Health Des MoinesUntil last fall Iowa Health Des Moines did not have a mechanism to help them determine how effective their medication reconciliation process truly was as they struggled to accurately and completely reconcile medications of their patients. It is through information that is gleaned from the audit process that it is learned what the problems are, the degree to which they exist, and what discipline is responsible for the error. Anecdotal information was available as a result of chart audits in heart failure and myocardial infarction. The Health Information's Management Department (HIM) managed an audit process to determine if medication reconciliation forms were on charts during 2007. Over a year ago, the medication reconciliation report was used less than 30% of the time by physicians to order discharge home medications.Though helpful in pointing out whether forms developed for medication reconciliation were used or not, it was clear there was a need for information to find out if the process worked as it should. A formal medication reconciliation audit process for in-patients was developed and implemented in September 2008.An online audit tool was developed and launched at that time. Unit representatives from the Nursing Clinical Quality Committee began auditing five charts per month. The audit includes a series of questions aimed at getting to essential information needed. Information is then used to help identify successes and opportunities for improvement.The facility has several inpatient units that have been testing different ways to improve the medication reconciliation processes and outcomes. One of the telemetry units's focused on improving the home discharge reconciliation process by insuring the physicians are reconciling the patient's home medications with the medications current as of the day of discharge. To do this, the nurses on the unit manually put the home medication list on the chart before the medication reconciliation report...

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