Sample Medication Reconciliation Form

ASC Durango (Colo.) recently underwent its first AAAHC survey and achieved accreditation. During the survey, it was brought to the attention of Cheryl Desko, RN, clinical director for the ASC, that the center’s patient post-op instructions were lacking in some areas, especially in medication review.

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“The surveyor didn’t feel that the patients were educated as to when they should take their medications once they got home,” she says. “We changed the medication reconciliation form to indicate the times that the patient received any medications and the nurse giving the instructions is now asking [patients to repeat the] instructions.”

 

To download a sample version of ASC Durango’s medication reconciliation form you can adapt for use in your own surgery center, click here (pdf).

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