Medication Card

Quick Links

Get your It’s Safe to Ask Medication Card Here Community Sites to get your It’s Safe to Ask Medication Card About E.R.I.K
Videos It’s Safe to Ask About
Your Medications
Implementation Tips Check List For Champions
About It’s Safe to Ask
Medication Card
SafeMedicationUse.ca The Canada Vigilance Program
Links to Tools and
Information
Sponsors Launch
Friends

About It’s Safe to Ask Medication Card

The It’s Safe to Ask Medication Card is for people to record medications. The purpose of the card is to

    1. 1. promote safe use of medications,
      2. encourage people to ask questions about their medications, and
      3. help healthcare providers and emergency responders know patients’ current medications

Get Your It’s Safe to Ask Medication Card here

Medication Card
(Adobe version)
Medication Card
(Microsoft Word Version)

medcard_pdf

Click here  to download.

 

  © Manitoba Institute for Patient Safety, 2008

 

medcard_word

Page 1
Page 2

 

© Manitoba Institute for Patient Safety, 2008. 

This version of the form can be downloaded and printed. Changes on the form cannot be saved to your computer. This version can be downloaded and saved to your computer. Changes to the form can be saved.

Medication Card
(For Professional Printing)
High Resolution Black&White

© Manitoba Institute for Patient Safety, 2008.

High Resolution Colour

© Manitoba Institute for Patient Safety, 2008. 

Disclaimer on Medication Card
This form does not replace medication orders given on how to take your medicine.  This is your personal medical information so please take care of it.

Medication Card to save to a computer

To save this Microsoft Word template and fill it in, follow the steps below:

    1. Click on the link to download Page 1 or Page 2 of the Medcard zip files. Save both files to your computer.
    2. Double click the downloaded file and a zip program will open showing the Micrsoft Word Medcard template. Then, double click the Medcard template file within the zip program.
    3. From the Menu, click File then select Save.
    4. Click the arrow down button from Save in, navigate to the location where you want to save the file.
    5. Under File Name, type the name of your file.
    6. Then click the Save button.
    7. Enter all your Medication information to the form. When done, click the
    File
    menu and then Print.
    8. Save your final changes by clicking File, then Save.
    9. Put the medcard in your wallet or ERIK.

To update the card

    1. Locate the Medication Card from your computer.
    2. Double click to open.
    3. Go to the line with old information.
    4. Click on “Format, Font, Effects, and check off “strikethrough”. This will save your old information
    5. Add your new information on a new line

Community sites to get your It’s Safe to Ask Medication Card

The Medication Cards are available from:

  • this website for downloading
  • local Senior Resource Councils (see information below)
  • participating pharmacies (those who print their own cards or order their cards from the Manitoba Society of Pharmacists)
  • participating physicians and primary care providers (those who print their own cards or order their cards from the Manitoba Institute for Patient Safety)

How Providers (physicians, pharmacies, health centre) can get their medication cards:

  • Community Pharmacists
    Order through Manitoba Society of Pharmacists. Call 956-6680 for information.
  • Physicians and Primary Care Providers
    Download from this website, or call 927-6477 to inquire about getting copies
  • Medication Reconciliation Teams
    Contacts will receive an order form in June to order medication cards.
  • Quality, Risk Management, Patient Safety Teams
    Contacts will receive an order form for medication cards in June, 2008.
  • Senior Resource Councils
    Contacts will receive medication cards to distribute to seniors in June 2008. Call 927-6477 for further information.

Poster

Print Poster to promote the medication card in your community.

Videos

Video 1 – FOR PUBLIC – Gives quick overview of Medication Card and tells why it is important.

Viewer

Download

video 1 banner.jpg

© Manitoba Institute for Patient Safety, 2008.

video 1 banner2.jpg

© Manitoba Institute for Patient Safety, 2008.

When image is click, a new window will open. To view the video, click the PLAY button. Click the image to start downloading the video. (Note: you must install a Flash player to play this file. We suggest you use FLV Player to play this video.)

Video 2 – FOR PUBLIC – Shows how to fill in and use the Medication Card. Tells why the Medication Card is important.

Viewer

Download

video 2 banner1.jpg

© Manitoba Institute for Patient Safety, 2008.

video 2 banner.jpg

© Manitoba Institute for Patient Safety, 2008.

When image is click, a new window will open. To view the video, click the PLAY button. Click the image to start downloading the video. (Note: you must install a Flash player to play this file. We suggest you use FLV Player to play this video.)

Video 3 – FOR PROVIDERS – Shows how to help patients fill in the Medication Card. Provides tips for taking a complete medication history. Tells why reconciling medications is important. Gives tips on improving communication with patients.

Viewer

Download

video 3 banner

© Manitoba Institute for Patient Safety, 2008.

video 3 banner1

© Manitoba Institute for Patient Safety, 2008.

When image is click, a new window will open. To view the video, click the PLAY button. Click the image to start downloading the video. (Note: you must install a Flash player to play this file. We suggest you use FLV Player to play this video.)

About E.R.I.K.®

E.R.I.K (Emergency Response Information Kit) is available from local Senior Resource Councils. Call 1-800-665-6565 to find out the phone number of the Senior Resource Council nearest you. Kits are also available from Fire and Paramedic Stations.

E.R.I.K. provides important information during emergencies in the home. The kit is ideal for seniors, people with chronic illnesses, those who live alone or who have caregivers, and others who have difficulty communicating. The It’s Safe to Ask Medication Card fits inside E.R.I.K.

TIPS for E.R.I.K. users:

  • Keep E.R.I.K on your fridge
  • Take your medication card with you to medical and dental appointments.
  • Return it to E.R.I.K. when you get home.
  • Take a copy of E.R.I.K. with you:
    • When you travel.
    • When you go to the hospital

In an emergency, paramedics will open the kit on your fridge and know:

  • What medications you take
  • If you have a Health Care Directive or Living Will
  • If you have signed an Organ Donation Card

It’s Safe to Ask About Your Medications

Tips Sheet for the public on asking questions about medications: It’s Safe to Ask!
Click Adobe Acrobat or MS Word link to download file. Save the MS Word file to your home computer and fill in your questions and answers.

Language Preference
Microsoft Word
Version (doc)
Adobe Acrobat
Version (pdf)
English Safe Use of Medications Safe Use of Medications
French Utilisation sans risque des médicaments Utilisation sans risque des médicaments

Implementation Tips Check List for Champions

This document is available into two versions

  • Click here to download Adobe Acrobat (pdf) file format
  • Click here download in MS Word (doc) file format

Links to Tools and Information

Articles

Medication Reconciliation Reference List (updated August 23, 2009)

Getting Started Kits, Medication Reconciliation, Safer Healthcare Now!
Acute Care – http://www.saferhealthcarenow.ca/Default.aspx?folderId=82&contentId=124
Long Term Care – http://www.saferhealthcarenow.ca/Default.aspx?folderId=82&contentId=1345

Patient and Family Involvement in Medication Safety

MIPS TIPS on Patient and Family Involvement . Health literacy sites, patient guides, and patient association.

Consumers Advancing Patient Safety. How to Create an Accurate Medication List in the Outpatient Setting Through a Patient Centered Approach.

Websites on Medication Safety

http://hqca.ca/index.php?id=100
www.ahrq.gov
www.bemedwise.org
www.bemedwise.ca
www.ismp-Canada.org
www.ismp.org
www.padis.ca
http://talkaboutrx.org

Medication Reconciliation Pamphlets – Winnipeg Regional Health Authority
Brochure on Medication Reconciliation for Staff (click here to download brochure)
Medication Safety Brochure for the Public (click here to download bilingual brochure)

Samples, Taking a Best Possible Medication History

Medication History Script
Example Script for Taking a Best Possible Medication History
- Print and Trim for your pocket

Winnipeg Regional Health Authority
Taking a Best Possible Medication History

Forms for Acute Care

St. Boniface General Hospital: Medications Prior to Admission – Reconciliation and Order Form
Admission form, for tertiary hospitals, used to collect and reconcile medications prior to admission.

St. Boniface General Hospital: Addendum to Medications Prior to Admission – Reconciliation and Order Form
On occasion, pharmacists, nurses and physicians may obtain new information about “home medications” and this form is to help improve the accuracy of the list.

Form for Community Care
Check back

Form for Discharge
Check back


Burntwood Regional Health Authority

Medication Reconciliation Admission Form (click here to download)

SafeMedicationUse.ca

Institute for Safe Medication Practises Canada (ISMP) has announced a pilot launch of their new consumer website, http://www.safemedicationuse.ca/. This website has been developed in order to expand the role of consumers in the Canadian Medication Incident Reporting and Prevention System (CMIRPS).

The site provides a consumer-friendly electronic medication incident reporting program, as well as a selection of targeted educational materials designed to support a proactive consumer role in medication safety.  Ultimately, the tools and knowledge provided by the SafeMedicationUse.ca site will equip consumers to become full participants in efforts to improve the safety of medication systems.

Click here to view the SafeMedicationUse.ca announcement.

The Canada Vigilance Program

The Canada Vigilance Program is Health Canada’s post-market surveillance program that collects and assesses reports of suspected adverse reactions to health products marketed in Canada. Post-market surveillance enables Health Canada to monitor the safety profile of health products once they are marketed to ensure that the benefits of the products continue to outweigh the risks.

http://www.safetoask.ca/wp-admin/http:\\www.healthcanada.gc.ca\medeffect

To report side effects of medications


http://www.hc-sc.gc.ca/dhp-mps/medeff/report-declaration/index-eng.php

Launch June 2, 2008

Media Release (English , French )

Media Backgrounders

Project Partners

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mpha (WinCE)

MSP Logo (WinCE)

WRHA

Sponsors

Platinum Level Supporter Level
gov mb

cpsi

Canadian Patient Safety Institute

Friends

inalco

mpha (WinCE)

MSP Logo (WinCE)