A journey of challenges with medication reconciliation
Background and purpose: Unintentional medication errors are a significant problem in terms of morbidity, mortality and cost. Medication reconciliation is one of several strategies to reduce medication errors. The purpose of this study was to examine accuracy of electronic medication reconciliation upon admission compared to discharge.
Method: A retrospective electronic chart review was conducted at a tertiary care safety-net hospital using a data extraction tool created for the study. Modifiable and non-modifiable factors related to medication reconciliation were analyzed using descriptive statistics.
Conclusions: The sample of 150 patients (mean age 58.8, SD 9.4) had more males and was predominately white. Results suggest prevalence of medication discrepancies were detected, corrected and significant in greater than 60% of discharge medication reconciliations. Eighty percent of patients were discharged home with a change in medication regime. Seventy-one percent patients reported to be on five medications or more. The most common comorbid illnesses included hypertension (86%), hyperlipidemia (67%), and coronary artery disease (60%).
Implications: Discharge Medication Reconciliation is costly in terms of nursing workload. Detected discharge medication reconciliation took 30 minutes or less to get discrepancies corrected. Delay in discharge to correct medication discrepancies may have a negative impact on patient satisfaction and financial management of the institution. Outcomes rely on health care provider’s ability to enter complete and accurate medication information in the medical record and to identify risk factors for medication discrepancies.
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
| Type | DNP Capstone Project |
| Acquisition | Self-submission |
| Review Type | Faculty Approved: Degree-based Submission |
| Format | Text-based Document |
| Evidence Level | Systematic Review |
| Research Approach | Other |
| Keywords | Medication Reconciliation; Medication Discrepancies; Admission; Discharge |
| MESH Subject(s) | Medication Reconciliation; Medication Errors |
| MESH Subject(s) | Medication Reconciliation; Medication Errors |
| Grantor | The State University of New York at Stony Brook |
| Advisor | Jurgens, Corrine |
| Level | DNP |
| Year | 2015 |
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