Medication Reconciliation

 

A medication calendar that contains all essential information on current therapy is a helpful tool for patients and health care providers. Creating a high quality complete medication calendar at transitions of care is important to facilitate patient engagement, avoid confusion and support safe medication management.

• A medication calendar MUST reflect the patient’s discharge prescription.
• A medication calendar must include (see example below):
  • patient identification (i.e. name, date of birth, health card number)
  • patient allergies/intolerances
  • date the calendar was created
  • name of healthcare provider creating the calendar
  • a list and schedule of current medications:
    • be consistent in naming the medications: use generic names, followed by any brand names in brackets
    • be sure to consistently specify the actual dose that the patient is taking, using the appropriate units (i.e. mg, mcg, IU), rather than number of tablets, for example:
      • venlafaxine XR 150 mg by mouth once daily (correct) VS. venlafaxine XR 75 mg 2 capsules by mouth once daily (incorrect)
    • indicate route of administration (i.e. by mouth, subcutaneously, etc.)
    • create a simple schedule that will be easy to follow. Keep in mind, if the patient’s medications need to be blister packed, the majority of packs can accommodate medication administration up to four times a day
    • include any special instructions (i.e. take on empty stomach, do not take within two hours before or after dairy food)
    • include indication  (i.e. state what the medication is for in language that the patient will understand
    • include medications to be used as needed and indicate what symptom they are for. Mark stars in the schedule (see example below).
    • indicate duration of treatment or next due date for applicable medications (indicate stop date/next due date under special directions).
    • list of medications discontinued/changed in the hospital
    • notes (i.e. additional follow up or monitoring for the patient)
• Review the calendar with the patient/family/caregiver, and confirm that they understand the information and what they must do. 
• Answer any questions that the patient/family/caregiver has about the medication calendar.

Sample medication calendar:

Find and print the Medication Calendar linked below through the NSHA/IWK Forms Inventory Listing on the Nova Scotia Health intranet, Forms page.

• Form name: NS_MC
• Description: Medication Calendar

To print bulk quantities of the form, use the applicable Dal Printing Services Requisition Form for your zone, found on the Nova Scotia Health intranet, Forms page.