Safe Medication Practices: Key to Preventing Errors Through the 3-WAY MATCH-BACK Process
Medication errors can have severe consequences in long-term care settings, making the implementation of safe medication practices a top priority for caregivers and providers. One essential process in preventing medication errors is the 3-WAY MATCH-BACK Process, a systematic approach to ensuring that prescriber orders, eMAR (electronic medication administration record) entries, and medications received from the pharmacy are consistently aligned. By performing thorough match-back reviews, care teams can safeguard residents’ health and maintain compliance with medication management standards.
What is the 3-WAY MATCH-BACK Process?
The 3-WAY MATCH-BACK process involves routinely comparing and aligning three key elements:
- Prescriber Orders: The original medication orders, signed by resident’s physician or healthcare provider.
- eMAR Entries: Records in the electronic medication administration system, which guide caregivers in administering medications.
- Medications Received from the Pharmacy: The physical medications delivered for residents.
This comprehensive review ensures that discrepancies are identified and resolved promptly, reducing the risk of medication errors and enhancing resident safety.
Complete Match-Back: Comprehensive Safety Checks
A Complete Match-Back involves reviewing the resident’s entire medication profile, ensuring that all prescriber orders, eMAR entries, and medications on hand are accurate and consistent. This process is critical during key transitions or as part of ongoing quality assurance efforts.
When to Perform a Complete Match-Back:
- At Admission: Verify all medication orders, including prescriber signature, and ensure accurate documentation and delivery upon a resident’s admission into the community.
- With Annual Medical Exams or Revised Plans of Care: Confirm changes to medications resulting from updated health assessments, medication lists, or care plans.
- After a Hospitalization or Care Transition: Reconcile medications to account for any changes made during a hospital stay or transfer in care setting.
Randomly, as Part of Quality Assurance: Conduct periodic audits to maintain high standards and identify potential gaps in medication management.
Partial Match-Back: Focused Reviews for New or Changed Orders
A Partial Match-Back focuses on recent changes to medication orders and deliveries, targeting new or updated information to ensure accurate implementation. This process complements the complete match-back by addressing ongoing updates and reducing the likelihood of errors from recent changes.
When to Perform a Partial Match-Back:
- With New Signed Prescriber Orders: Verify new prescriptions or changes to existing ones.
- During Daily or Cycle Deliveries from Pharmacy: Check that medications received from pharmacy match the updated eMAR.
- When Flags or Alerts Appear in the eMAR: Investigate and resolve any discrepancies flagged by the system.
- With Discontinued Orders: Confirm that discontinued medications are no longer listed or administered and that medications are stored separately from active orders.
Steps to Perform a Match-Back for a New Resident
A structured approach ensures accuracy and consistency during the match-back process. Below are the steps to perform a match-back when admitting a new resident:
- Review Prescriber Orders:
- Collect and review all orders for completeness, including prescriber signature.
- Send the orders to the pharmacy for fulfillment.
- Match eMAR Entries with Prescriber Orders:
- Compare the entries in the eMAR with your copy of the prescriber orders.
- If the orders match, approve them in the eMAR.
- If discrepancies exist, contact the pharmacy to resolve the issue before approval.
- Match Medications from the Pharmacy to eMAR Entries:
- Upon delivery, compare the medications received to the eMAR entries.
- If the medications match, store them appropriately.
- If there are discrepancies, contact the pharmacy immediately.
By ensuring alignment at every step, caregivers can confirm that the prescriber’s orders, eMAR, and medication labels match.
Verify the Rights of Medication Administration
Beyond the match-back process, caregivers should always adhere to the Rights of Medication Administration. These seven principles serve as a final safeguard to prevent errors:
- Right Patient: Ensure the medication is administered to the correct resident using two identifiers.
- Right Drug: Verify the medication name matches the prescriber order and the eMAR.
- Right Dose: Confirm the dosage is accurate.
- Right Time: Administer the medication at the correct time.
- Right Route: Ensure the medication is given via the correct method (e.g., oral, injection).
- Right Reason: Confirm the medication aligns with the resident’s condition.
- Right Documentation: Record all administration and monitoring details accurately in the eMAR.
The Importance of the 3-WAY MATCH-BACK Process
The MATCH-BACK process is a cornerstone of safe medication practices in long-term care settings. By prioritizing these reviews, communities can prevent medication errors, improve resident outcomes, and build trust among residents and their families. Whether performing a complete or partial match-back, consistent vigilance in medication management promotes a culture of safety and quality care.
Empower your team to embrace these best practices and safeguard residents’ health through diligent medication management. The MATCH-BACK process isn’t just a task—it’s a commitment to excellence in care.

Brandy Chiles, RN
Director, Clinical Services
Boomer Solutions – A Guardian Pharmacy
Brandy is a seasoned long-term care and public health nurse with a strong passion for education, purposeful planning and resourcing of care to meet the needs of older adults and individuals with complex care needs. She earned her BSN from Northeastern State University and currently serves as the Director of Clinical Services for Boomer Solutions – a member of the Guardian family of pharmacies – where she leads clinical, educational, and client success strategies for three Oklahoma pharmacies.