Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

5-2-2018

Degree Program

Doctor of Nursing Practice

Degree Track

Psychiatric Mental Health Nurse Practitioner (PMHNP)

Year Degree Awarded

2018

Month Degree Awarded

May

Keywords

medications, medication reconciliation, medication safety, medication list, psychiatric

Advisor

Donna Zucker

DNP Project Chair

Donna Zucker

Abstract

Purpose: To improve medication safety among behavioral health patients at a community-based outpatient psychiatric practice in Western Massachusetts through implementation of an evidence-based medication reconciliation protocol.

Methods: Gaps in the current medication reconciliation process were identified by reviewing the current process with outpatient supervisors in the practice. A sample of 25 patients, the majority with more complex comorbid medical conditions, were selected to participate in an evidence-based medication reconciliation process. Medications, both prescribed and over the counter, were reconciled either in office or in the home.

Results: There was a significant increase in the number of medications identified post-intervention. On average patients were taking 4.1 additional non-psychiatric medications not identified in the EMR and 2.3 OTC medications also not identified in the EMR. Missing from the EMR were 103 (88%) non-psychiatric medications and 57 (100%) OTC medications. Results also reflected that those who were reconciled at home (non-compliant with in office process) had: more missing medications (mean 5.54 vs 3.42) in the EMR as well as a higher potential for drug interactions total (mean 1.46 vs 0.54).

Conclusion: Results of this intervention were clinically significant as they reflected substantial differences between medications listed in patients’ electronic medical record vs. what they were actually prescribed or taking; thus, a higher potential for adverse drug events.

Included in

Nursing Commons

Share

COinS