Patient Safety

1. Patient Safety …. Don’t get sick in July…..

2. What Can I do as a Medical Student?

3. What you can do • Be a patient advocate • Pay attention • Ask questions

4. Medication Reconciliation • Take this on this year…..

5. Reconciliation?Bringing together, making “right”

6. What is medication reconciliation? • "the process of comparing a patient's medication orders to all of the medications that the patient has been taking. “

7. Why? • Avoid medication errors: • Omissions • Duplications • Dosing errors • Drug interactions

8. When? • Every transition of care in which new medications are ordered or existing orders are rewritten. • Transitions in care: • Changes in setting, service, practitioner or level of care • Patient moves from one unit to another • Patient moves from one service to another • Patient is admitted to the hospital • Patient is discharged from the hospital • Patient enters or leaves rehab, assisted living, or nursing home • Patient changes physicians • Patient sees new physician (subspecialist) in consultation

9. 5 Steps: • Develop a list of current medications • Develop a list of medications to be prescribed • Compare the medications on the two lists • Make clinical decisions based on the comparison • Communicate the new list to appropriate caregivers and to the patient.

10. Your part… • Review medication profile with the patient to assure it is correct and up-to-date • Discontinue all non-active medications • Renew all expired medications • Prescribe new medications not on the medication profile including OTC, herbal, and traditional medications • All prescriptions will contain the indication for prescribing (to address health literacy)

11. Next part… • Patient needs to receive a copy of the list: • In real words • No abbreviations • Think about health literacy • Write out indication for each medication • Include in the medical record: At UNC, help to update the medication list in WebCis….

12. When can you help? • At admission: • Pharmacists will be in ED to help with obtaining accurate medication lists on patients being admitted: Emergency Department Pharmacy Technician Team • 7 am-10 pm Mon-Friday • 9 am- 5 pm Saturday, Sunday, holidays • Contact information on handouts and on website ….

13. At Discharge • Students often initiate creation of the discharge summary • Medication Reconciliation crucial! • Go through home medications (use information obtained from ED team, yourself, family, patient, facility) • Go through current medications in hospital • Justify use of each medication • Make sure no duplications • Use Generic names!!! • Update medication list in WebCis • Specify what changes were made and why!

14. Patient Safety…. • What can you do? Take this on, improve quality of care, and ….

15. And… • Become the MVS (Most Valuable Student) for the team!