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It should be done at every transition of care in which new medications are ordered or existing orders are rewritten. Transitions in care include changes in setting, service, practitioner, or level of care.
Upon receipt of the information from the pharmacy, the nurse can be required to reconcile the list from the patient and the pharmacy with new medications ordered by the physician upon admission. This is a process that must be completed by the physician/prescriber.
Medication Reconciliation -- The process of identifying the most accurate list of all medications that the patient is taking, including name, dosage, frequency, and route, by comparing the medical record to an external list of medications obtained from a patient, hospital, or other provider.
Upon receipt of the information from the pharmacy, the nurse can be required to reconcile the list from the patient and the pharmacy with new medications ordered by the physician upon admission. This is a process that must be completed by the physician/prescriber.
Medicines reconciliation is the process of identifying an accurate list of a person's current medicines and comparing it with the current list in use.

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Define the Steps in the Reconciliation Process IHI suggests three steps to the process: (1) verify by collecting the list of medications, vitamins, nutritional supplements, over-the-counter drugs, and vaccines; (2) clarify that the medications and dosages are appropriate; and (3) reconcile and document any changes.
1 The goals of medication reconciliation are to obtain and maintain accurate and complete medication in- formation for a patient and use the information within and across the continuum of care to ensure safe and effective medication use.
This process comprises five steps: (1) develop a list of current medications; (2) develop a list of medications to be prescribed; (3) compare the medications on the two lists; (4) make clinical decisions based on the comparison; and (5) communicate the new list to appropriate caregivers and to the patient.
Examples of Medication Reconciliation A patient receiving for hypertension was admitted for surgery. The admitting resident did not order on admission due to concerns about perioperative hypotension.
Examples of Medication Reconciliation A patient receiving for hypertension was admitted for surgery. The admitting resident did not order on admission due to concerns about perioperative hypotension.

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