What are essential steps of medication reconciliation at admission, transfer, and discharge?

• A. Verify the patient's allergies and stop any high-risk meds if needed.
• B. Educate the patient on changes only.
• C. Document changes only without reviewing current meds.
• D. Collect current meds, compare with new orders, resolve discrepancies, educate the patient, and document changes.

Answer: (D)

The essential steps of medication reconciliation across admission, transfer, and discharge focus on building an accurate medication list and ensuring it matches what is ordered, then communicating changes to the patient and the care team. Start by collecting the patient’s current medications from the patient, family, and available records to get a complete picture. Then compare that list with the new or changed orders to spot discrepancies such as omissions, duplications, incorrect doses, or potential interactions. Resolve any discrepancies by consulting with the prescriber and updating the medication list accordingly. Educate the patient (and caregivers) about any changes so they understand what to take and why, and document all changes in the chart so every team member has a current, shared plan. This sequence helps prevent medication errors during transitions and supports continuity of care.

Other options fall short because they focus on only one part of the process—such as just addressing allergies or stopping high‑risk meds, or only educating or only documenting—without the full set of steps needed to ensure an accurate and safe medication plan at each transition.