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To ensure patient safety and promote compliance with the JCAHO Medication Reconciliation National Patient Safety Goal, it is critical that the following steps occur:
Build the Pre-Admission Medications List (PAML) prior to ordering admission medications
For every medication listed on the PAML, choose a planned action on admission (PAA) from the drop down list. This is the first step of the reconciliation process.
After choosing all PAAs, sign the list with the PAML Creation: Complete option checked. This electronically signals the pharmacist to review the home list against the admission meds. This is an important and helpful second reconciliation step.
BWH Information Systems staff are actively working to create a link from PAML to BICS order entry to help the workflow of medication ordering. The steps listed above are required for information to flow from the PAML to order entry.
Medication reconciliation is a high priority for both patient safety and accreditation. The Pre-Admission Medications List (PAML) is a tool with several purposes:
Gathering and verifying a complete record of the medications a patient has been taking before admission
Indicating if and how those medications will be administered during the inpatient visit
Presenting those medications for processing at discharge
The pre-admission medication list is one of the documents required for medication reconciliation. It should be used to facilitate communication with the patient, family, and any caregivers who can provide information on the patient's medications prior to admission.
The PAML Builder is accessible for all inpatients.
All medications except those flagged to hold or discontinue should have a corresponding medication order written in BICS Order Entry. Medications may be held for the entire visit, or until completion of a procedure—write the orders as appropriate to the course of care. Medications may be held for the entire visit, or until completion of a procedure—write the orders as appropriate to the course of care. These medication orders are NOT written automatically when the medications are recorded in the PAML.
See Also
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