Quality of medication information in discharge summaries from hospitals: an audit of electronic patient records.

Background Low quality of medication information in discharge summaries from hospitals may jeopardize optimal therapy and put the patient at risk for medication errors and adverse drug events. Objective To audit the quality of medication information in discharge summaries and explore factors associated with the quality. Setting Helgelandssykehuset Mo i Rana, a rural hospital in central Norway.

Should nurses or clinical pharmacists perform medication reconciliation? A randomized controlled trial.

Purpose: To study differences in outcomes of medication reconciliation (MR) when performed by clinical pharmacists compared to nurses.

Methods: 201 patients (21-92 years) admitted to the Department of Cardiology at the University Hospital of North Norway, autumn 2012, were randomized into a pharmacist group (PG) and a nurse group (NG). The nurses and the pharmacists were trained for performing the MR process by an independent clinical pharmacist.