Medication reconciliation at hospital discharge: A qualitative exploration of acute care nurses’ perceptions of their roles and responsibilities

Abstract

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Barriers and Facilitators of Communication in the Medication Reconciliation Process during Hospital Discharge: Primary Healthcare Professionals’ Perspectives

“…It therefore seems necessary to generate standardized protocols and processes for communication between primary healthcare professionals, and to reduce workloads in consultation to improve care and free up time for professionals to hold coordination meetings, clinical sessions and other activities that improve the exchange of information and teamwork. In fact, teamwork has been identified in our study, and in others [13], as an important facilitator of medication reconciliation in primary healthcare. Other studies showed that a good relationship between healthcare professionals is key to the continuity of care for patients, especially in older adults with polypharmacy and multipathological condition [39,57].…”

“…However, they do perceive the existence of technologies, such as computerized medical records, as a facilitator, although it seems that even after two decades of its implementation, they are still seen as insufficient mediums for exchanging information. This feeling is enhanced by the fact that the current tool (Diraya) appears to have not improved this communication exchange, given its structure and the display of varied and inexact information based on the healthcare professional's profile, which obliges them to look for new and more precise information [13,29,41,42]. This becomes difficult because the healthcare professionals are already overburdened with work and have little or no time available.…”

“…In itself, polypharmacy is a criterion of frailty in older adults and a risk factor for mortality and morbidity as it increases the risk of drug interactions, increases the risk of anticholinergic and sedative burden [8], decreases therapeutic adherence and demands greater use of health resources [7,9]. Numerous studies have also argued that transitions between levels of care are a source of discrepancies in medication, medical errors and potentially adverse events [10][11][12], occurring mainly in the transition from hospital care to primary healthcare, after hospital discharge [10,[13][14][15][16]. The WHO states that more than 40% of medical errors occur in the transition from hospital to home [1].…”

“…The difficulties in the medication reconciliation process have been related to care overload and lack of time [3,13,21], lack of training, knowledge and skills of healthcare professionals [17,21], lack of standardization in the medication reconciliation process [22,24] and the dissolution of medication reconciliation responsibility among healthcare professionals due to ambiguity over who should assume responsibility and execute it [17,24].…”

Journey of medication reconciliation compliance in a lower middle-income country: a retrospective chart review

“…According to a study done in Australia, more than 60% of nurses think that time constraints and staffing shortages are obstacles to optimal medication reconciliation. 6 …”