Last weekend I met a nurse from Springfield, Missouri. Springfield is 45 minutes from Joplin, the site of a recent devastating tornado. Her name is Lisa. When given the opportunity to speak with nurses from different parts of the country, I enjoy hearing about the state of nursing in their particular locale. I brought up the CHAMP Program and asked Lisa about her take on the state of geriatric medication management. My interest was piqued when I heard her say that she had just completed serving a year on her hospital’s Medication Reconciliation Improvement Committee. Lisa told me that as a hospital Admissions Nurse she’s responsible for medication reconciliation. Mentioning the difficulties experienced with the elder population, Lisa spoke of her challenges day after day. Often times the patient doesn’t know much about the medications they take at home. The family doesn’t know much either sometimes. Even determining the names of the pharmacies the patient uses can be an exercise in futility. Sound familiar? As a result of her committee’s work, Lisa’s hospital now has a team of “assistants” who help track down an accurate list of patient medications. They call pharmacies, physicians in the community, family members etc. in their quest for information. I asked Lisa if home care nurses were considered as a part of her hospital’s approach to this problem. I was disappointed to hear Lisa say “No”.
My conversation with Lisa reminded me of opportunities that exist for home care nursing. On the home care side we experience the same issues with medication reconciliation as the hospital. Although I think home care nursing has a distinct advantage by providing our care in a place where the patient lives. We see the china dish filled with an assortment of colorful pills sitting on the side table. A shoebox filled with expired prescription med bottles from various providers is often within our reach. Medication reconciliation should be something hospital and home care nurses share and communicate about. I know that there are a lot of health care experts (who have an alphabet soup full of degrees) working on this issue. Those who provide the care should be a part of this discussion also. How about offering to serve on a hospital committee? After all, we are the ‘experts’ when it comes to medication management and the elderly at home!
Share the work that you’ve been doing on medication reconciliation by posting your story below. I’d be especially interested in hearing about collaborations between hospital and home care. Your fellow home care nursing colleagues will be interested too!
Debra Bertrand, CHAMP Facilitator
