All homecare providers know that medication reconciliation upon admission is challenging. It requires investigation, communication, and accuracy. The Centers for Disease Control and Prevention (CDC) conducted a study which found that four types of high risk medications account for two-thirds of emergent hospital admissions: warfarin, insulin, oral antiplatelets, and oral hypoglycemics.

 

Warfarin is used to prevent blood clots; insulin and oral hypoglycemic are used to control blood sugar in diabetics; and antiplatelets, including aspirin, are used to prevent platelets from clumping together and forming a blood clot. Often, these medications involve follow-up lab work and frequent dosage adjustments. Homecare agencies should ensure that their medication reconciliation process addresses these and other high risk medications to include the monitoring of patients on these medications closely and implementation of thorough patient education programs.

 

Though all medications require review and reconciliation at admission and throughout the care delivery process, high risk medications should throw up a red flag. Helpful tips include implementing patient education sheets that address high risk medications and other common medications to make the education process easier on homecare clinicians. In patient’s emergency plans, include high risk medications and complications to be alert for. Upon admission, educate on high risk medications first. They should be made a priority in the process.