Revising the Role of Nursing in Medication Reconciliation-A Clinical Nurse Specialist guided implementation

2.50
Hdl Handle:
http://hdl.handle.net/10755/164081
Category:
Abstract
Type:
Presentation
Title:
Revising the Role of Nursing in Medication Reconciliation-A Clinical Nurse Specialist guided implementation
Author(s):
Garolis, Salomeja
Author Details:
Salomeja Garolis, RN, MS, CNS, CMS, Providence Portland Medical Center, Portland, Oregon, USA, email: sabineja.garolis@providence.org
Abstract:
PURPOSE/OBJECTIVES: Generate one single legible medication reconciliation list for patients at discharge. Significance: Transitions in care settings are high-risk related to patient medication information. Both admission and discharge reconciliation is key to ensure accurate ongoing therapy. The IHI points to inaccuracy of medication reconciliation at discharge as a major factor in readmission of patients. BACKGROUND/RATIONALE: Providence Portland Medical Center received feedback from patients, providers, and community partners that the current handwritten form was confusing, and often not legible. Incorporated in the form was both admission and discharge medication information. Driven by patient safety and the need to improve accuracy of patients home medication lists, the Chief Medical Officer commissioned an interdisciplinary team to meet three objectives: Simplify existing medication reconciliation process; Clarify roles; Produce one single complete medication list for patients at discharge. DESCRIPTION: A thorough review of current electronic applications by the team led to the decision to utilize the nursing longitudinal charting application to support the reconciliation process. Nursing would now be accountable for electronically entering and updating prior to hospital medication. Physicians would be accountable for completing the reconciliation process. The discharge update was new workflow to incorporate into a nurse's day. Time studies detailed the process as an additional weekly 2.5FTE. The CNS facilitated nursing leadership to endorse an innovative role of medication reconciliation nurse to support bedside nurses with discharge medication updates. These nurses work in a separate physical location, have no competing demands, and focus solely on updating medications. This role utilizes the wisdom of nurses who want to stay clinically engaged but cannot keep up with physical demands of bedside care. Unit super trainers supported staff in the first weeks of go-live. Unit rounding done the CNS addressed questions and logged issues. OUTCOME: The medication reconciliation nurses update 75% of daily patient discharges. Bedside nurses focus on direct care and reviewing the final list with their patient at discharge. This role continues to be adjusted to maximize staff support. INTERPRETATION/CONCLUSION: The medication reconciliation nurses update 75% of daily patient discharges. Bedside nurses focus on direct care and reviewing the final list with their patient at discharge. This role continues to be adjusted to maximize staff support. IMPLICATIONS FOR PRACTICE: Complex change can be implemented through CNS influence and leadership.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2010
Conference Name:
CNS as Interal Consultant: Influencing Local to Global Systems
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Portland, Oregon, USA
Description:
Conference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleRevising the Role of Nursing in Medication Reconciliation-A Clinical Nurse Specialist guided implementationen_GB
dc.contributor.authorGarolis, Salomejaen_US
dc.author.detailsSalomeja Garolis, RN, MS, CNS, CMS, Providence Portland Medical Center, Portland, Oregon, USA, email: sabineja.garolis@providence.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/164081-
dc.description.abstractPURPOSE/OBJECTIVES: Generate one single legible medication reconciliation list for patients at discharge. Significance: Transitions in care settings are high-risk related to patient medication information. Both admission and discharge reconciliation is key to ensure accurate ongoing therapy. The IHI points to inaccuracy of medication reconciliation at discharge as a major factor in readmission of patients. BACKGROUND/RATIONALE: Providence Portland Medical Center received feedback from patients, providers, and community partners that the current handwritten form was confusing, and often not legible. Incorporated in the form was both admission and discharge medication information. Driven by patient safety and the need to improve accuracy of patients home medication lists, the Chief Medical Officer commissioned an interdisciplinary team to meet three objectives: Simplify existing medication reconciliation process; Clarify roles; Produce one single complete medication list for patients at discharge. DESCRIPTION: A thorough review of current electronic applications by the team led to the decision to utilize the nursing longitudinal charting application to support the reconciliation process. Nursing would now be accountable for electronically entering and updating prior to hospital medication. Physicians would be accountable for completing the reconciliation process. The discharge update was new workflow to incorporate into a nurse's day. Time studies detailed the process as an additional weekly 2.5FTE. The CNS facilitated nursing leadership to endorse an innovative role of medication reconciliation nurse to support bedside nurses with discharge medication updates. These nurses work in a separate physical location, have no competing demands, and focus solely on updating medications. This role utilizes the wisdom of nurses who want to stay clinically engaged but cannot keep up with physical demands of bedside care. Unit super trainers supported staff in the first weeks of go-live. Unit rounding done the CNS addressed questions and logged issues. OUTCOME: The medication reconciliation nurses update 75% of daily patient discharges. Bedside nurses focus on direct care and reviewing the final list with their patient at discharge. This role continues to be adjusted to maximize staff support. INTERPRETATION/CONCLUSION: The medication reconciliation nurses update 75% of daily patient discharges. Bedside nurses focus on direct care and reviewing the final list with their patient at discharge. This role continues to be adjusted to maximize staff support. IMPLICATIONS FOR PRACTICE: Complex change can be implemented through CNS influence and leadership.en_GB
dc.date.available2011-10-27T11:41:40Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:41:40Z-
dc.conference.date2010en_US
dc.conference.nameCNS as Interal Consultant: Influencing Local to Global Systemsen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationPortland, Oregon, USAen_US
dc.descriptionConference theme: CNS as Internal Consultant: Influencing Local to Global Systems, held March 3 - 6, Portland, Oregon, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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