Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
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.
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