Date of Award

Summer 2020

Document Type

Final DNP Paper

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chair

Dr. Arlinda Wormely

Abstract

Background: Medication reconciliation creates a significant safety risk when patients transition from one care environment to another. This is especially true for older adults who may have multiple medications, poor health literacy, or multiple providers. During care transitions, collecting accurate information about previous medication regimens can be a challenge. If providers are unskilled at eliciting the needed information, discrepancies can result, leading to medication errors, poorer outcomes, or patient harm. These discrepancies, if unresolved, can follow the patient throughout hospitalization and back into the outpatient setting, leaving patients unable to manage their care at home safely.

Purpose: The objective of this project was to determine if the use of dedicated, highly trained nurse champions to collect medication histories at the point of hospital admission had a significant impact on the number of medication history discrepancies.

Design Methods: This project included in-class training of 18 nurse champions in best practice recommendations to collect the best possible medication history on high-risk patients admitted to the inpatient setting. After the training, chart reviews were conducted, with multiple source verification, to identify any discrepancies in the medication regimen resulting from errors of omission, addition, dosing, route, or frequency. Conclusion: Following training, the nurse champions decreased the average number of errors in the medication history from 4.38 errors per patient (SD = 2.94) to 1.28 errors per patient (SD = 1.85), far exceeding the project goal of a 15% reduction in discrepancies (p <0.001).

Implications for Nursing: In smaller hospitals with limited resources, the use of nurse champions provides an effective option for improving the medication reconciliation process and promoting medication safety.

Included in

Nursing Commons

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