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Medication Reconciliation

Medication reconciliation is the process of comparing a patient’s medication orders to all of the medications that the patient has been taking. This reconciliation is done to avoid medication errors such as omissions, duplication, dosing errors, or drug interactions. It should be done at every transition of care in which new medications are ordered or existing orders are rewritten. Transitions in care include changes in setting, service, practitioner, or level of care.

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Nurse Practitioners

Nurse practitioners treat both physical and mental conditions through history taking, physical exams, and ordering tests for qualified physicians to interpret. NPs can provide a nursing diagnosis and recommendations for a wide range of acute and some chronic diseases (within their scope of practice) and provide appropriate treatment for patients, including prescribing medications in somstates. NP’s can see patients of all ages depending on their specialty (family, pediatrics, geriatrics, etc.). Similar to all medical professions, the core philosophy of the field is individualized care that focuses on patients’ conditions as well as the effects of illness on the lives of the patients and their families. NPs make prevention, wellness, and patient education priorities. To become licensed/certified to practice, Nurse Practitioners hold board certification in an area (such as family, women’s health, pediatrics, adult, acute care, etc.), and are licensed through the state nursing boards. NPs must practice within the scope of their certification.

According to the International Council of Nurses, an NP/advanced practice nurse is “a registered nurse who has acquired the knowledge base, decision-making skills and clinical competencies for expanded practice beyond that of an RN, the characteristics of which would be determined by the context in which s/he is credentialed to practice.”

Additional advanced practice RN roles include the certified registered nurse anesthetist (CRNA)s, CNMs, and CNSs.

Nurse practitioners can be educated and certified in areas of family health (FNP), pediatrics, including pediatric acute/chronic care, pediatric critical care, pediatric oncology and general pediatrics (PNP), neonatology (NNP), gerontology (GNP), women’s health (WHNP), psychiatry & mental health (PMHNP), acute care (ACNP), adult health (ANP), oncology (FNP, ACNP, ANP, PNP or ANP) emergency (as FNP or ACNP), occupational health (as ANP or FNP), etc. In Canada, NPs are licensed by the province or territory in which they practice.

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Polypharmacy – Why we Avoid

Polypharmacy (also called polymedicine) is the use of multiple medications by a patient.It sometimes alternatively refers to purportedly excessive or unnecessary prescriptions.The variant “polymedicine” is less likely than “polypharmacy” to bear the negative connotation of excess (and it is also more likely to refer to multiple drugs treating a single disease, known better as combination therapy),but both terms lack for universally consistent definition.

Benefits of polypharmacy can include enhanced efficacy of treatment as well as improved safety and tolerance of pharmacotherapy. Concerns about polypharmacy include increased adverse drug reactions, drug-drug interactions, and higher costs. Polypharmacy is most common with the elderly.

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