Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
5-5-2018
Degree Program
Doctor of Nursing Practice
Degree Track
Family Nurse Practioner
Year Degree Awarded
2018
Month Degree Awarded
May
Keywords
medication reconciliation, adverse drug interactions, outpatient, multi-disciplinary, adverse drug events, medical error
Advisor
Raeann LeBlanc
Abstract
Abstract
Background: Medication safety is a focus of the Joint Commission’s National Patient Safety Goals and research supports improved medication reconciliation as a strategy to reduce medication errors and adverse drug events. In a busy, outpatient specialty clinic where patients are routinely considered for high-risk pharmaceutical therapies, a consistent medication reconciliation process is essential for patient safety and positive health outcomes. Purpose: To improve consistency of medication reconciliation in this high-risk outpatient setting. Method: Based on a gap analysis between evidence-based and current practice, a quality improvement intervention was implemented to increase patient engagement in the medication reconciliation process. A reminder prompt was added to automated appointment notification calls and staff provided verbal cues to patients along with a printed copy of the medication list for review during the check-in and rooming process. A report was created to capture whether medication reconciliation was completed at the same time as provider-patient visits, and rates of reconciliation completions were calculated. Results: Prior to implementation of this project, medication reconciliation completion rates were calculated at an average of 35.6% over the three months prior. During the six-week intervention period, reconciliation rates improved in the range of 4.4-10.7% over that of the pre-intervention average rate. Medication list completeness and accuracy, however remain a challenge. Conclusion: Increased patient engagement showed a positive effect on medication reconciliation completion rates in the outpatient setting but did not surpass the goal of at least 50% reconciled. Further interventions, including staff training to improve competency in comprehensive, accurate medication reconciliation is warranted.
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