Run Medication Reconciliation Audit — Free

Audit Details

Care transition audited critical (required)

Select the transition point being audited.

Audit date and time

Record when the audit was completed.

Unit or care area

Enter the unit, clinic, or care area where the reconciliation was reviewed.

Auditor name

Enter the name and role of the person completing the audit.

Home Medication List Verification

Home medication list obtained from a reliable source critical (required)

Verify whether the home medication list was collected from the patient, caregiver, pharmacy, prior records, or another reliable source.

Yes No N/A

Medication name, dose, route, and frequency documented for each home medication critical (required)

Check that each listed home medication includes complete identifying details.

Yes No N/A

Allergies and adverse reactions documented and visible critical (required)

Confirm allergies and prior adverse drug reactions are documented in the record and available to the care team.

Yes No N/A

Last dose information documented for high-risk or time-sensitive medications

Verify last dose timing is documented when clinically relevant, such as for anticoagulants, insulin, opioids, anticonvulsants, or inhalers.

Yes No N/A

Medication list reviewed with patient or caregiver when feasible

Confirm the list was validated with the patient, caregiver, or another appropriate source when possible.

Yes No N/A

Discrepancy Identification and Resolution

Unintentional discrepancies identified and documented critical (required)

Check whether omissions, duplications, dose changes, route changes, frequency changes, or drug interactions were identified and documented.

Yes No N/A

Discrepancies resolved by prescriber or authorized clinician critical (required)

Verify that unresolved differences were clarified and resolved by an authorized clinician.

Yes No N/A

Reason for medication changes documented

Confirm the chart includes a reason for additions, discontinuations, substitutions, or dose adjustments.

Yes No N/A

High-alert medications independently verified

Confirm high-alert medications were verified using an independent double-check or equivalent safety process when applicable.

Yes No N/A

Admission and Transfer Medication Orders

Current medication orders match the reconciled list critical (required)

Verify that active orders align with the reconciled medication list for the current level of care.

Yes No N/A

Medications intentionally held, substituted, or discontinued are clearly documented

Confirm the record shows which medications were intentionally not continued and why.

Yes No N/A

Transfer handoff includes updated medication list critical (required)

Verify the receiving team has access to the updated medication list and any pending clarification items.

Yes No N/A

Medication reconciliation completed within facility policy timeframe

Enter the elapsed time from admission or transfer to completion of reconciliation.

Discharge Reconciliation and Patient Education

Discharge medication list matches final reconciled orders critical (required)

Verify the discharge medication list reflects all final medication changes and intended continuations.

Yes No N/A

Patient or caregiver received medication education

Confirm education was provided on new, changed, and discontinued medications, including purpose and key precautions.

Yes No N/A

Follow-up instructions for medication questions or concerns documented

Verify the discharge record includes who to contact for medication-related questions and when to seek help.

Yes No N/A

Teach-back or understanding verified when applicable

Confirm the patient or caregiver demonstrated understanding of the discharge medication plan when feasible.

Yes No N/A

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Run: Medication Reconciliation Audit

Audit Details

Home Medication List Verification

Discrepancy Identification and Resolution

Admission and Transfer Medication Orders

Discharge Reconciliation and Patient Education

Get your results