Emergency Nurses Association Position Statement: Medication Management and Reconciliation in the Emergency Setting

      Medication reconciliation remains a patient safety issue worldwide. In the United States, The Joint Commission (TJC) began pivoting focus from medication reconciliation toward overall medication management when introducing the seven foundations for safe quality transitions of care in 2013.
      Agency for Healthcare Research and Quality (AHRQ)
      Medication reconciliation.
      Medication management as one of the foundations broadly includes activities such as verification, prescribing, administration and monitoring used in conjunction with the current National Patient Safety Goals (NPSG) on medication reconciliation. Medication management is intended to safeguard patients from medication errors and adverse drug events (ADEs) during transitions between care settings, including emergency departments, urgent cares centers, other ambulatory emergency settings or other types of care settings.
      Agency for Healthcare Research and Quality (AHRQ)
      Medication reconciliation.
      U.S. Centers for Medicare and Medicaid Services
      Medicare promoting interoperability program modified stage 2 eligible hospitals, critical access hospitals, and dual-eligible hospitals attesting to CMS objectives and measures for 2018 Objective 5 of 7.
      World Health Organization
      The High5s Project – assuring medication accuracy at transitions in care: standard operating protocol for medication reconciliation.
      World Health Organization
      Medication safety in transitions of care.
      Agency for Healthcare Research and Quality (AHRQ)
      The guide to improving patient safety in primary care settings by engaging patients and families. Implementation quick start guide: Medication management.
      • Labson M.C.
      Adapting The Joint Commission’s seven foundations of safe and effective transitions of care to home.
      • Mekonnen A.B.
      • McLachlan A.J.
      • Brien J.A.
      Pharmacy-led medication reconciliation programmes at hospital transitions: A systematic review and meta-analysis.
      • Nguyen C.
      • Shane R.
      • Bell D.
      • Cook-Wiens G.
      • Pevnick J.
      A time and motion study of pharmacists and pharmacy technicians obtaining admission medication histories.
      • Nguyen T.L.
      • Leguelinel-Blache G.
      • Kinowski J.M.
      • et al.
      Improving medication safety: development and impact of a multivariate model-based strategy to target high-risk patients.
      The Joint Commission
      Transitions of care: the need for collaboration across entire care continuum. Hot Topics in Health Care, Issue #2. Accessed April 12, 2021.
      The Joint Commission
      Quick safety issue 26: transitions of care: managing medications. Published August 26, 2016. Accessed April 12, 2021.
      Medication management is more than just an accurate medication history or reconciliation. The three phases of the reconciliation process are imperative to ensure effective medication management and obtaining an as complete and accurate medication history is the first step.
      Agency for Healthcare Research and Quality (AHRQ)
      The guide to improving patient safety in primary care settings by engaging patients and families. Implementation quick start guide: Medication management.
      Medication management and reconciliation in the emergency setting is a collaborative effort between nurses, physicians, pharmacists, and patients to reduce risk for patients in health care settings and at home.
      Agency for Healthcare Research and Quality (AHRQ)
      Medication reconciliation.
      ,
      Agency for Healthcare Research and Quality (AHRQ)
      The guide to improving patient safety in primary care settings by engaging patients and families. Implementation quick start guide: Medication management.
      ,
      • Mekonnen A.B.
      • McLachlan A.J.
      • Brien J.A.
      Pharmacy-led medication reconciliation programmes at hospital transitions: A systematic review and meta-analysis.
      ,
      The Joint Commission
      Transitions of care: the need for collaboration across entire care continuum. Hot Topics in Health Care, Issue #2. Accessed April 12, 2021.
      ,
      The Joint Commission
      Quick safety issue 26: transitions of care: managing medications. Published August 26, 2016. Accessed April 12, 2021.
      ,
      • Mardani A.
      • Griffiths P.
      • Vaismoradi M.
      The role of the nurse in the management of medicines during transitional care: a systematic review.
      • Ortmann M.J.
      • Giesler Johnson E.
      • Jarrell D.H.
      • et al.
      ASHP Guidelines on emergency medicine pharmacist services.
      This process requires that health care providers, including emergency nurses, communicate clearly with patients and their caregivers about the importance of maintaining an accurate medication list.
      • Mekonnen A.B.
      • McLachlan A.J.
      • Brien J.A.
      Pharmacy-led medication reconciliation programmes at hospital transitions: A systematic review and meta-analysis.
      ,
      • Mardani A.
      • Griffiths P.
      • Vaismoradi M.
      The role of the nurse in the management of medicines during transitional care: a systematic review.
      , An accurate medication list includes all medications including prescriptions, over-the-counter medications, supplements, herbals, medicinal marijuana, known allergies and last dose.
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