Implementation of a Medication Reconciliation Nurse in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162443
Type:
Presentation
Title:
Implementation of a Medication Reconciliation Nurse in the Emergency Department
Abstract:
Implementation of a Medication Reconciliation Nurse in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2011
Author:Scott, Claire, RN, BSN, CEN
P.I. Institution Name:Aultman Hospital
Title:Patient Care Specialist
Contact Address:2600 Sixth Street SW, Canton, OH, 44710, USA
Contact Telephone:330-363-0644
[ENA Leadership Conference] Evidence-based Practice Presentation: Implementation of a Medication Reconciliation Nurse in the Emergency Department

Purpose: To provide accurate and timely medication reconciliation to Emergency Department (ED) patients. The ED was asked to provide a summary of the issues and barriers it faced in completing medication reconciliation to the hospital Medication Reconciliation Committee. This report included data demonstrating that ED nursing staff spent an average of 20 hours per day completing medication reconciliation for approximately 240 patients on a daily basis. Based on the findings in this report and a 62% accuracy rate for medication reconciliation completed in the ED, a proposal was presented to the Chief Nursing Officer (CNO) of the hospital to hire 2.4 FTEs to support medication reconciliation in the ED.

Design: This is a quality improvement project utilizing the Plan Do Check Act format.

Setting: This project takes place in an 800 bed, urban, level II mid-western trauma center.

Participants/Subjects: The hospitalÆs Medication Reconciliation Committee. The ED clinical informatics nursing knowledge expert. The ED medication reconciliation nurses. Two ED charge nurses.

Method: The ED was first approached in February of 2009 to send a representative to the Medication Reconciliation Committee to present the issues the ED faced in completing medication reconciliation. In September of 2009, a proposal was presented to the CNO to grant 2.4 FTEs for the creation of a medication reconciliation nurse in the ED. The position was approved on a trial basis. Twenty nurses were selected as the core group of medication reconciliation nurses. This group of nurses was provided with 1:1 education including details of medication reconciliation and its electronic medical record documentation. Each ED medication reconciliation nurse collects data during their shift. This includes, but is not limited to; time to complete individual medication reconciliations, patient admission status and extra measures taken to obtain accurate medication lists. The nurse also copies five patient medication lists to be audited by ED charge nurses each shift.

Results/ Outcomes: From October 2009 to June 2010 audits showed an increase in accuracy of medication reconciliation performed in the ED from 62% to 99%. Anecdotally, patient, nursing and physician satisfaction improved. Press Ganey patient satisfaction scores increased from 91.8 to 92.0 with "Nurse took time to listen" showing consistent increases. The position was later approved by the CNO as a permanent position.

Implications: Through implementation of a dedicated medication reconciliation nurse, ED patients now have their medications reviewed and reconciled at the point of entry to the hospital by a specially trained medication reconciliation nurse. This has greatly improved the accuracy of the medication reconciliations initiated in the ED and in turn, has provided more direct care time for the ED nurse. The increased satisfaction from the ED and admitting physicians, as well as the admitting unit's staff, supports positive patient outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementation of a Medication Reconciliation Nurse in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162443-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementation of a Medication Reconciliation Nurse in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2011</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Scott, Claire, RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Aultman Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Patient Care Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">2600 Sixth Street SW, Canton, OH, 44710, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">330-363-0644</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">cscott@aultman.com</td></tr><tr><td colspan="2" class="item-abstract">[ENA Leadership Conference] Evidence-based Practice Presentation: Implementation of a Medication Reconciliation Nurse in the Emergency Department<br/><br/>Purpose: To provide accurate and timely medication reconciliation to Emergency Department (ED) patients. The ED was asked to provide a summary of the issues and barriers it faced in completing medication reconciliation to the hospital Medication Reconciliation Committee. This report included data demonstrating that ED nursing staff spent an average of 20 hours per day completing medication reconciliation for approximately 240 patients on a daily basis. Based on the findings in this report and a 62% accuracy rate for medication reconciliation completed in the ED, a proposal was presented to the Chief Nursing Officer (CNO) of the hospital to hire 2.4 FTEs to support medication reconciliation in the ED.<br/><br/>Design: This is a quality improvement project utilizing the Plan Do Check Act format.<br/><br/>Setting: This project takes place in an 800 bed, urban, level II mid-western trauma center.<br/><br/>Participants/Subjects: The hospital&AElig;s Medication Reconciliation Committee. The ED clinical informatics nursing knowledge expert. The ED medication reconciliation nurses. Two ED charge nurses. <br/><br/>Method: The ED was first approached in February of 2009 to send a representative to the Medication Reconciliation Committee to present the issues the ED faced in completing medication reconciliation. In September of 2009, a proposal was presented to the CNO to grant 2.4 FTEs for the creation of a medication reconciliation nurse in the ED. The position was approved on a trial basis. Twenty nurses were selected as the core group of medication reconciliation nurses. This group of nurses was provided with 1:1 education including details of medication reconciliation and its electronic medical record documentation. Each ED medication reconciliation nurse collects data during their shift. This includes, but is not limited to; time to complete individual medication reconciliations, patient admission status and extra measures taken to obtain accurate medication lists. The nurse also copies five patient medication lists to be audited by ED charge nurses each shift.<br/><br/>Results/ Outcomes: From October 2009 to June 2010 audits showed an increase in accuracy of medication reconciliation performed in the ED from 62% to 99%. Anecdotally, patient, nursing and physician satisfaction improved. Press Ganey patient satisfaction scores increased from 91.8 to 92.0 with &quot;Nurse took time to listen&quot; showing consistent increases. The position was later approved by the CNO as a permanent position. <br/><br/>Implications: Through implementation of a dedicated medication reconciliation nurse, ED patients now have their medications reviewed and reconciled at the point of entry to the hospital by a specially trained medication reconciliation nurse. This has greatly improved the accuracy of the medication reconciliations initiated in the ED and in turn, has provided more direct care time for the ED nurse. The increased satisfaction from the ED and admitting physicians, as well as the admitting unit's staff, supports positive patient outcomes. <br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:28:18Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:28:18Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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