Nurse-Led Medication Reconciliation and Reduction of Medication Errors at Hospital Discharge

Abstract

ABSTRACT Medication discrepancies at hospital discharge can arise when pre-admission medicines, inpatient treatment changes, and the final discharge prescription are not systematically compared and communicated. The World Health Organization identifies transitions of care as a priority area for medication safety, while the Agency for Healthcare Research and Quality describes medication reconciliation as a structured comparison of medication regimens to identify and resolve discrepancies.[1,2] This quasi-experimental manuscript evaluates a nurse-led medication reconciliation bundle among adults discharged from medical-surgical wards. The illustrative sample included 200 adults, with 100 receiving usual discharge care and 100 receiving the nurse-led intervention. The intervention included obtaining a best possible medication history, comparing medication lists, escalating unresolved discrepancies, confirming the final medication list, patient/caregiver teach-back, and communication of medication changes. Illustrative results showed at least one medication error in 34% of usual-care patients versus 18% of intervention patients. Documentation completeness and teach-back performance were also higher in the intervention group. These numerical findings are simulated for manuscript development and are not actual clinical results. The paper supports prospective evaluation of nurse-led reconciliation as a structured discharge safety process.

KEYWORDS: medication reconciliation; medication errors; hospital discharge; nursing; patient safety; transitions of care; teach-back