Archive June 2017 XVIII, No. 6

Ideas That Work: Medication Reconciliation Form Doubles as Rx Pad

medication reconcilliation formDownload a sample medication reconciliation form that you can adapt for your facility at

Medication Reconciliation Form Doubles as Rx Pad

If you're still charting on paper, you might consider combining your prescription pad with your medication reconciliation form. For starters, you won't have to chase after your doctors to sign the reconciliation form; they can do so when they sign the script. Second, when the patient takes the combined form to the pharmacy, the pharmacist can see the patient's drug history and any allergies. To save the hassle of making copies, make up the form in triplicate. The top copy goes to the pharmacy if an Rx is written (be sure to use security paper; shred the top copy if there's no prescription), the middle copy goes in the chart and the bottom copy goes to the patient at discharge.

Dawn Ashby, RN, BSHA, CNOR, CASC
North Hills Surgery Center
Fayetteville, Ark.

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