Authors (including presenting author) :
Tse YN(1), AuYeung HC(1), Ng LW(1)
Affiliation :
(1)Orthopaedics & Traumatology, Tseung Kwan O Hospital
Keyword 1: :
Medication Reconciliation
Keyword 2: :
safety practice
Keyword 3: :
Medication safety
Introduction :
Medication incidents are a significant category in Serious Untoward Events. Any medication errors may lead to patient harm, and there is zero tolerance for them regarding patient safety. When discussing 'medication,' we often recall the '3 checks and 5 rights.' Nevertheless, medication reconciliation is equally important. It’s essential to have accurate records before applying the '3 checks and 5 rights' to help prevent medication errors that could harm patients. According to the World Health Organization (2014), around half of the medication errors occurred in hospitals on admission or discharge from a clinical unit or hospital and around 30% of these errors have the potential to cause patient harm. Up to 67% of patients’ prescription medication histories recorded on admission to hospital have one or more errors. Maintaining vigilance in medication reconciliation can effectively prevent medication incidents and reduce potential harm to patients. Therefore, it is essential to enhance nurses’ awareness of medication reconciliation before acknowledging prescriptions to improve safety measures.
Objectives :
This project aimed to improve nurses’ awareness, competency and confidence in medication reconciliation, establish and align standardized checkpoints and workflow with WM, and provide accessible reference tools and a compliance checklist for monitoring adherence. By reducing medication incidents and strengthening patient safety, the initiative seeks to ensure accurate medication reconciliation during admissions and transfer-in.
Methodology :
Quasi-experimental design was used with several key steps in this project. First, medication reconciliation procedures were standardized and aligned with Ward Manager to ensure consistency in medication reconciliation. A set of clear checkpoints for verifying medication history was developed, along with a compliance checklist to monitor adherence. Second, prompting tools, cue cards and posters, outlining key tips for medication reconciliation, were created and placed on ward computers for quick reference and easy access. Then, training sessions were conducted to educate nursing staff about the different sources of obtaining the most up-to-date medication record, with demonstrations of the standard procedures of medication reconciliation. Lastly, participants were also required to redemonstrate their competency in these procedures with a pre & post quiz to assess knowledge retention and the level of confidence.
Result & Outcome :
By September 2025, all 25 nurses (100% of Ward 7B staff) had completed the training and achieved full competency certification. Post-evaluation showed that 100% of participants reported strong confidence in performing medication reconciliation independently. The project has successfully embedded medication reconciliation as a core nursing safety practice in daily workflow, ensuring sustainability through continuous monitoring and integration into orientation for newcomers. Also, annual ongoing audits and refresher training sessions will be conducted.
