The Role of Medication Reconciliations in Patient Safety

Author: Megan Bereda, PharmD Candidate

Communication is the Key

While on my adult medicine rotation, I had the opportunity to work with patients, round with the medical team, and provide recommendations to help improve patient care. At the beginning of my experiential learning, it was intimidating to be thrown into a role where I was helping make decisions that directly impacted patients. Often, I found it very difficult to make clinical decisions without truly knowing my patients or what kind of care they needed. I soon realized that the best way to determine exactly what my patients needed was to talk to them directly.

Improving the Medication Reconciliation Process

During my adult medicine rotation, a 25-year-old male was brought in to the emergency room (ER) by his mother due to seizures at home. Both pharmacy and nursing work together in the ER to complete the medication reconciliation process and obtain the patient’s medication history. In this case, the patient told the nurse that he took clonazepam 1 mg daily, so it was recorded in the system and physician ordered 1 mg clonazepam.

Connecting with Community through Medication Safety

Over the last year, I had the opportunity to live and learn in east Baltimore studying public health. While knowing that I would only be residing in Baltimore for about one year, I wanted to engage in the community and get to understand some of the lives of the people who live there as best as I could. Two distinct experiences, which I’ll highlight now, shed light on the power of community and the importance of medication safety practice.

In a Blink

Popping her head in, the nurse urgently requested “Benadryl and Solu-Medrol –stat!” The pharmacist, recognizing the urgency of the situation, rapidly compounded the medications. Curious, I followed the nurse to the patient room and saw the unresponsive patient. Her face was white, yet her body was red and sweaty. Her blood pressure had dropped to an alarming 80/50. She was moaning, but not responding to questions. This patient, a kind lady in her mid-sixties, was the same patient I had exchanged pleasantries with a mere five minutes ago. How could her status change in a blink?

Safety During the Drug Development Process

Commercial drug development is a time-intensive, elaborate, and nuanced process that has held my fascination throughout pharmacy school. However, I have failed to realize how crucial a role patient safety plays during drug development.  At CMSA, I have learned that every minute detail of a medication is precisely engineered, from the drug formulation and appearance of the medication container to the drug’s brand name and where it may be stored at a pharmacy.

Communication and Trust

During my infectious disease inpatient rotation, I had the opportunity to hear a patient’s perspective after an adverse drug event, which showed me the importance of communication after an error occurs.

The Importance of Counseling Patients on their Medications

Throughout pharmacy school, we were taught the importance of using the teach-back method when counseling a patient on his or her medication. Personally, I thought this idea was idealistic but unrealistic. Community pharmacies are busy and pharmacists may often struggle to find time to talk to patients. However, I realized the importance of using this method during one of my rotations at a hospital based outpatient pharmacy.

Medication Safety at Summer Camps

I remember hearing about the opportunity to go to a camp for a rotation and immediately liked the idea. It was a week of hanging out with kids, doing camp activities, and then getting some time off afterwards. I knew that I would have a role in taking care of medications, but beyond that, I really had no idea what to expect.

Pharmacists and Medication Adherence

During my Forensic Diversion and Community Corrections rotation, one of my weekly tasks was to go to the County Work Release and perform medication counts. Work Release is a “middle-ground” facility between prison and home detention. Before entering Work Release, participants must turn in all of their medications, from over-the-counter products to controlled substances.


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