1. Alderwood Rest Home Brenda Nicholson, Director of Resident Care

3. Who We Are: 70 bed facility We provide care to residents who require level 1 and 2 care 70% of admissions per year(last year) Population served approx.150,000 primarily rural residential elderly clients in Cape Breton

4. AIM Statement To decrease the potential for medication discrepancies to zero on admission and during transfer from hospital

5. Team Members Administrator, RNs, LPNs, Pharmasist, Physician, Dietician and Director of Care Crucial in making med rec successful at Alderwood was the nurse coordinator, Pharmacist and Director of Care

6. Change Ideas Using multiple sources for data collection – MARs, medical status report, sometimes pharmacy and family. Depending if the person is being admitted from home, hospital or another LTC home. –Start BPMH before the person arrives

7. Change Ideas Use BPMH to get admission orders Add forms to admission package

8. Change Idea: Combined Form

9. Results At baseline we exceeded 6 discrepancies per resident admission The last 4 admissions had ZERO discrepancies!

10. Lessons Learned Physicians & nursing staff to be on board Surprised at the number of discrepancies on admission Quickly decreased the number of discrepancies but it took 8 months to reach goal It is valuable to measure and use results to improve the reconciliation process

11. Challenges Data entry was definitely a challenge for us at Alderwood. Some Physician/Nurses were and are frustrated with the process and more so in acute care, as this is where we often see most of our potential errors. Prescribing physician often not family physician

12. Currently Nursing staff are starting to see the benefits of the BPMH: –it is time consuming prior to admission –preventing discrepancies/errors and rework

13. Next Steps Work with DoCs to standardize routine med protocols Reconcile medication on discharge Need to consider appropriateness of medication

14. Thank you! Contact Information: Brenda Nicholson Alderwood Rest Home Baddeck, Nova Scotia Email: brenda.alderwood@hotmail.combrenda.alderwood@hotmail.com Phone: 902 295-2644