The Meaning of Medication Reconciliation and Its Importance
What is medication reconciliation? It’s one of the most powerful processes nurses have to prevent medication errors. But there’s a greater importance and meaning of medication reconciliation that relates to the overall quality of health services. Every time a patient is admitted, transferred, or discharged, important medications, like blood thinners, can get missed or accidentally duplicated. Without a thorough review, these small errors can lead to serious problems. Done correctly, this process can literally save lives — and protect your nursing license too.
So, how is medication reconciliation (medication recon for short) done, and why does it matter? Keep reading to learn what it is, how to do it properly, and how it affects nursing care more than you might think.
Medication Recon Stats
- Medication errors are deadly: They cause at least one death every day and injure 1.3 million people in the U.S. each year.
- A global financial burden: Medication errors cost healthcare systems around $42 billion annually — nearly 1% of global health spending.
- Discrepancies are alarmingly common: One study found that up to 77% of patients with chronic conditions had at least one medication discrepancy, usually due to omissions, changes, or substitutions.
- Transitions are high-risk moments: Around half of hospital medication errors occur during admission, transfer, or discharge.
- Older adults face greater risk: Patients over 65 and those on multiple medications are significantly more likely to experience serious medication errors.
- Medication errors drive readmissions: About 22% of hospital readmissions are linked to medication-related issues.
- Nurses make a difference: Studies show that nurses and pharmacists identify 30% to 70% of medication-ordering errors.
Medication Reconciliation: Definition and Importance
Medication reconciliation is the systematic process of reviewing all of a patient’s medications — including prescriptions, over-the-counter drugs, herbal supplements, and vitamins — to identify and resolve any discrepancies. It’s especially critical during care transitions, such as admission, transfer, or discharge, when the likelihood of medication errors increases.
Why is medication reconciliation important? It plays a key role in preventing adverse drug events (ADEs), which are a major cause of patient harm worldwide. Effective reconciliation can reduce medication discrepancies by up to 70%, ensuring patients get the right medications, doses, and care at every transition.
In addition, medication recon helps build trust between a patient and a nurse, as well as between a nurse and an interdisciplinary team. When a nurse followings the process to ensure patient safety, it demonstrates not only that the nurse is detail-oriented but also that the nurse can be counted on to properly carry out patient care plans. As you can see, the meaning of medication reconciliation is greater than simply following directions.
Medication Errors to Watch for During Reconciliation
Medication reconciliation in nursing isn’t just about reviewing meds — it’s also about catching medical errors before they lead to harm. Here are the common types of medication discrepancies to watch out for:
| Discrepancy Type | Medication Reconciliation Example |
|---|---|
| Omission | A necessary medication is accidentally left out or not ordered.Example: A patient who takes insulin at home doesn’t have it reordered upon hospital admission. |
| Duplication | The same medication is listed or given more than once, often under different names.Example: A beta blocker is prescribed twice — once by brand name and once by generic. |
| Wrong time | The medication is taken at the wrong time or outside of its prescribed schedule.Example: A time-sensitive antibiotic is delayed, reducing its effectiveness. |
| Improper dose | The patient receives too much, too little, or an incorrectly prepared dose.Example: A child is given an adult dose due to a calculation error. |
| Unauthorized medication | A medication is given without proper authorization or not intended for that patient.Example: A pharmacy dispenses medication to the wrong patient due to a labeling error. |
| Administration errors | Mistakes are made while giving the medication, such as: Wrong route (e.g., IV instead of oral) Extra or missed dose Wrong patient Incorrect infusion rateExample: A patient swallows a chewable tablet instead of chewing it, reducing its effectiveness |
| Prescribing errors | Errors are made when writing the prescription, such as: Incorrect drug choice Inappropriate dose Failure to consider patient history or allergiesExample: A patient allergic to penicillin is prescribed amoxicillin. |
| Monitoring errors | The patient isn’t monitored or assessed properly before or after administering the medication.Example: Warfarin is prescribed without scheduling regular INR checks, increasing bleeding or clotting risk. |
| Compliance errors | Established rules, policies, protocols, or legal regulations related to medication use aren’t followed.Example: A provider adjusts a patient’s insulin dose over the phone but the nurse forgets to update the electronic health record (EHR), and the next shift nurse uses the outdated dose. |
What Is the Medication Reconciliation Process?
We’ve answered the question, What is medication reconciliation?, but you may still be curious about how it’s done. Think of it as a five-step safety check that helps ensure every medication a patient needs is safely continued, adjusted, or discontinued. Here’s how it’s done:
1. Create a List of Current Medications
Let’s say a nurse is performing medication reconciliation with a client. How does it begin? Start by gathering a full list of everything the patient is currently taking — prescription medications, over-the-counter (OTC) drugs, herbal supplements, vitamins, and even occasional-use medications like sleeping aids or pain relievers.
Review not just the list but also the actual pill bottles, if the patient brought any. Some medications sound alike, so a patient might say they take “metoprolol” but actually mean “metoclopramide.” You might also want to call the patient’s pharmacy, caregiver, or family members to ensure you have the most accurate list of current medications.
Tip: Ask open-ended questions like, “What do you take for your blood pressure?” or “Do you use anything to help you sleep?”
2. Review Medications That Are Being Ordered
Next, carefully examine the medications that are being prescribed for the patient in the current care setting. This includes any new medications, changes to existing treatments, or medications that are planned to be stopped. Pay close attention to doses, schedules, and any special instructions.
Tip: It’s important to identify high-risk medications. Double-check if any critical medications like blood thinners or insulin have been administered or adjusted, as these often require close monitoring. Examples of such medications can include the following:
- Anti-infectives
- Potassium and other electrolytes
- Insulin
- Narcotics and other sedatives
- Chemotherapeutic agents
- Heparin and anticoagulants
- Other high-risk medications identified as such at your unit, facility, or state
3. Review Medication Lists
Once you have the patient’s current medication list and the new orders, compare both carefully to identify any discrepancies. What is medication reconciliation like in your facility? Check out your workplace policies to know the exact process you’re expected to follow. Here’s an example to give you an idea of what to look for during this step:
- Omissions (medications that are missing)
- Duplicates (same drug listed under different names)
- Changes in dose, frequency, or route
- Potential interactions with new meds
Example: A patient takes metformin and glyburide at home for type 2 diabetes, but only insulin is ordered on admission. This may be intentional, or it could be an oversight that leads to poor blood sugar control if not clarified.
4. Resolve Any Discrepancies
Based on your review, collaborate with the healthcare team to resolve any discrepancies. This may involve clarifying unclear orders, deciding whether to continue, adjust, or stop certain medications, and considering patient-specific factors like allergies, kidney function, or potential drug interactions.
Here’s an example of questions to ask when going through this step:
- Was this medication intentionally stopped or adjusted?
- Is the dose appropriate for this setting (e.g., renal function or weight)?
- Are there any allergies or contraindications to consider?
- Has the patient been taking any non-prescribed supplements or herbal remedies that could affect this medication?
Tip: When resolving discrepancies, think beyond medications — consider the patient’s lifestyle and preferences. Sometimes, switching to a once-daily dose can significantly improve med compliance.
5. Communicate the Updated Medication List
The meaning of medication reconciliation is just as relevant to providers as it is to patients: It’s indicative of effective communication between all members of the care team. Therefore, the final step of the process is to clearly share the updated medication list with everyone involved — the patient, caregivers, family, and treatment team. Take the time to sit down and review the list with the patient. Do they have any questions? Oftentimes, this discussion uncovers additional issues that need follow-up.
Make sure the updated list is accurately documented in the patient’s medical records and shared with all relevant healthcare providers to ensure continuity of care.
Tip: Give the patient a printed or electronic copy of their updated medications and instructions. If they have a history of skipping doses, suggest using nurse apps like MyMedSchedule to help them track their meds easily.
Looking for High-Quality Nursing Jobs?
The meaning of medication reconciliation is more than just a process — it’s also a trust-building endeavor among providers as well as patients. Now, are you ready to make the most out of your nursing career? IntelyCare can help you find quality jobs that check all your boxes — tailored to your career ambitions and lifestyle goals.