Doctor of Nursing Practice (DNP) Projects

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Doctor of Nursing Practice

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Psychiatric Mental Health Nurse Practitioner (PMHNP)

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


Donna Zucker

DNP Project Chair

Donna Zucker


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

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