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Preceptor: Dr. Emily Beckett
Current Medication Reconciliation Process at a Community Family Health Clinic: Pilot Study Brittany Bittner, Ana Glavas, Samantha Marquardt, & Karli Welter Preceptor: Dr. Emily Beckett
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Background Location: Broadlawns Family Health Center, Des Moines IA
Provides comprehensive primary and preventative health care for the entire family The clinics population demographics often involve the underserved population
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Objective Establish a policy and procedure regarding the best practices for the medication reconciliation process
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Methods Pre Pilot Post Reminder phone calls to patients Nursing survey
/ Methods Pre Reminder phone calls to patients Nursing survey Develop medication reconciliation process and medication pocket card template Pilot Nursing staff reviews and practices policy Input all changes to patients' medication lists into our online data collection questionnaire Post Nursing Survey Identify and implement necessary changes to the new policy
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Nursing Survey - Rating System
Nurses rated their response on a scale of 1-5: 1= fully agree 2= somewhat agree 3= neither agree nor disagree 4= somewhat disagree 5= fully disagree
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Nursing Survey I feel accurate medication lists are important to deliver good patient care. Broadlawns current medication reconciliation process is efficient at accurately updating each patient medication list. I feel comfortable with the current medication reconciliation process. I feel comfortable completing medication reconciliations with patients. I always go through each medication on the medication list with every patient and accurately update the EMR. The current EMR technology at Broadlawns allows me to accurately perform medication reconciliations and update medication lists.
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Data Collection During Pilot Study
How many medications is the patient on? (Rx and OTC) How many medications were added? How many medications were deleted? Were there changes to dosage strength? Were there changes to dose frequency? How many doses does the patient miss weekly on average?
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Survey Results Questions Pre-Survey Post-Survey I feel that accurate medication lists are important to deliver good patient care 1.50 1.00 Broadlawns current medication reconciliation process is efficient at accurately updating each patient medication list 2.75 1.40 I feel comfortable with current medication reconciliation process 2.13 1.20 I feel comfortable completing medication reconciliation with patients 1.63 I always go through each medication on the medication list with every patient and accurately update the EMR 1.88 The current EMR technology at Broadlawns allows me to accurately perform medication reconciliation and update medication lists 2.25 1.60
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Data Collection Results
199 patients seen in clinic during pilot study 178 patients eligible to participate in pilot study 35 responses from nursing staff Average Prescription Medications Per Patient 9.09 Average OTC Medications Per Patient 2.49
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Data Collection Results
Average Number of Changes to Each Medication List = 1.8 updates
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Reported Reasons for Deletions
Reason for Deletion Number of Respondants (n = 17) Unknown 12 Duplicate Medications 2 Medication Changed to Another Agent 1 Therapy No Longer Needed Adverse Drug Reaction Inadequate Therapy Allergic Reaction
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Reported Reasons for Changes in Dosage Strength and Frequencies
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Conclusions and Implications
Unknowns with MediTech Nursing Survey Results Average Number of Changes to Each Medication List Remains a work in progress We expect more changes to be made when the nursing staff continues to follow the new medication reconciliation process
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Questions?
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