What is the nurse's role in medication safety and reconciliation at transitions of care?

• A. Do not communicate changes across settings.
• B. Reconcile only on hospital admission.
• C. Reconcile only for high-risk medications.
• D. Verify and reconcile medications across settings, communicate changes, ensure patient understanding, and monitor for interactions.

Answer: (D)

Transitional care is a high-risk moment for medication errors, so the nurse’s role centers on creating a complete, accurate medication picture and ensuring it travels with the patient across settings. This means actively verifying what the patient is taking by gathering a current med list from the patient and family, consulting previous charts, pharmacy records, and other care settings, then comparing that list with the new orders. Any discrepancies—omissions, duplications, incorrect doses, or routes—are identified and resolved in collaboration with prescribers and pharmacists, and the updated list is documented in the patient’s record.

Communication is essential. Changes made during transitions must be clearly conveyed to all involved providers and to the patient and family, so everyone understands what to take, what was stopped or started, and why. The patient (and family) should receive education about the medication plan, including how to take each medication, potential interactions to watch for, and when to seek help.

Monitoring for interactions and adverse effects is also part of this role. After a transition, the nurse watches for new or worsened drug interactions, allergies, or contraindications and ensures follow-up or reconciliation at discharge with the next level of care.

Reconciliation is not limited to a hospital admission or to high-risk medications; it should occur at every transition and encompass all medications. That comprehensive, patient-centered approach is why this option is correct.