2.50
Hdl Handle:
http://hdl.handle.net/10755/182980
Category:
Abstract
Type:
Presentation
Title:
Medication Reconciliation: The Bedside Nurse Leading Achievement and Sustainability
Author(s):
Sitterding, Mary
Author Details:
Mary Sitterding, MSN, CNS, CNRN, Columbus Regional Hospital, Columbus, Indiana, USA, email: msitterdin@crh.org
Abstract:
Paper Presentation: The influence of medication reconciliation on patient safety is remarkable. Harm result from loss of medication information as patients traverse the system. Re-work related to the loss of information is significant. Medication errors and adverse drug events in the hospital are due to poor communication at handoffs. Medication reconciliation is a process of identifying the most accurate list of medications and using this list to provide care for a patient whatever their setting. Error related to medication reconciliation is happening on every shift, in every nursing unit, in every hospital, in every city. Professional nursing practice cultures embrace a complex adaptive systems approach to problem identification, solution generation and testing positioning the beside nurse to lead the achievement, spread, and sustainability of this safety priority. Complex Adaptive Systems theory was applied to examine and influence structures, processes, and patterns. Quality improvement tools to identify and reduce variation were employed. The team examined and reduced wasted steps transitioning from 42 to 8 steps. The team that includes 15% leadership and 85% bedside nurses and pharmacists designed an automated solution that eliminated the need for transcription. This team conducts unit-based audits to understand progress toward process and outcome indicators influencing admission, transfer, and discharge reconciliation. Weekly connections led by the bedside nurse champion and facilitated by the CNS have influenced spread and sustainability. Based upon this improvement methodology, admission reconciliation accuracy has moved from 50 - 96% accuracy while discharge accuracy has moved from 28% to 95% accuracy. References: Griffen, F. (2005) Global Trigger Tool. Paper presentation at the IHI Hospital Summit, June 2005 Federicko, F. (2005) Medication Reconciliation. Paper presentation at the IHI Hospital Summit, June 2005 Institute Healthcare Improvement (2005) Getting Started ADE: Medication Reconciliation How-to Guide. Institute of Medicine of the National Academies. Committee on the Work Environment for Nurses and Patient Safety. (2004) Keeping Patients Safe: Transforming the Work Environment of Nurses. The National Academies Press. Leonard, M., Frankel, A., Simmonds, T. & Vega, K. ( 2004) Achieving Safe and Reliable Healthcare: Strategies and Solutions. Institute for Healthcare Improvement Plsek, P. (2002) Spreading Good Ideas for Better Health Care: A Practical Toolkit. VHA Plsek, PE, Wilson, T. "Complexity science: complexity, leadership, and management in healthcare organisations." British Medical Journal, September 29, 2001; 323: 746-749 Reason, J. "Human errors: models and management." British Medical Journal. March 18, 2000, 320(7237): 768-70 Rozich, J.D., Haraden, C.R., Resar, R.K. (2003) Adverse drug event trigger tool: a practice methodology for measuring medication related harm. British Medical Journal Publishing Group and Institute for Healthcare Improvement. Rozich, J.D., Resar, R.K., et. al. Standardization as a mechanism to improve safety in health care: impact of sliding scale insulin protocol and reconciliation of medication initiatives. Joint Commission Journal on Quality and Safety. 2004 Womack, J., Jones, D., and Roos, D. (1990). The Machine that Changed the World. The Story of Lean Production. Zimmerman, B. , Lindberg, C., Plsek, P. ( 1998) Edgeware Insights from Complexity Science for Health Care Leaders.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2006
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Denver, Colorado, USA
Description:
10th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 4-6 October, 2006 at the Colorado Convention Center in Denver, Colorado, 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.titleMedication Reconciliation: The Bedside Nurse Leading Achievement and Sustainabilityen_GB
dc.contributor.authorSitterding, Maryen_US
dc.author.detailsMary Sitterding, MSN, CNS, CNRN, Columbus Regional Hospital, Columbus, Indiana, USA, email: msitterdin@crh.orgen_US
dc.identifier.urihttp://hdl.handle.net/10755/182980-
dc.description.abstractPaper Presentation: The influence of medication reconciliation on patient safety is remarkable. Harm result from loss of medication information as patients traverse the system. Re-work related to the loss of information is significant. Medication errors and adverse drug events in the hospital are due to poor communication at handoffs. Medication reconciliation is a process of identifying the most accurate list of medications and using this list to provide care for a patient whatever their setting. Error related to medication reconciliation is happening on every shift, in every nursing unit, in every hospital, in every city. Professional nursing practice cultures embrace a complex adaptive systems approach to problem identification, solution generation and testing positioning the beside nurse to lead the achievement, spread, and sustainability of this safety priority. Complex Adaptive Systems theory was applied to examine and influence structures, processes, and patterns. Quality improvement tools to identify and reduce variation were employed. The team examined and reduced wasted steps transitioning from 42 to 8 steps. The team that includes 15% leadership and 85% bedside nurses and pharmacists designed an automated solution that eliminated the need for transcription. This team conducts unit-based audits to understand progress toward process and outcome indicators influencing admission, transfer, and discharge reconciliation. Weekly connections led by the bedside nurse champion and facilitated by the CNS have influenced spread and sustainability. Based upon this improvement methodology, admission reconciliation accuracy has moved from 50 - 96% accuracy while discharge accuracy has moved from 28% to 95% accuracy. References: Griffen, F. (2005) Global Trigger Tool. Paper presentation at the IHI Hospital Summit, June 2005 Federicko, F. (2005) Medication Reconciliation. Paper presentation at the IHI Hospital Summit, June 2005 Institute Healthcare Improvement (2005) Getting Started ADE: Medication Reconciliation How-to Guide. Institute of Medicine of the National Academies. Committee on the Work Environment for Nurses and Patient Safety. (2004) Keeping Patients Safe: Transforming the Work Environment of Nurses. The National Academies Press. Leonard, M., Frankel, A., Simmonds, T. & Vega, K. ( 2004) Achieving Safe and Reliable Healthcare: Strategies and Solutions. Institute for Healthcare Improvement Plsek, P. (2002) Spreading Good Ideas for Better Health Care: A Practical Toolkit. VHA Plsek, PE, Wilson, T. "Complexity science: complexity, leadership, and management in healthcare organisations." British Medical Journal, September 29, 2001; 323: 746-749 Reason, J. "Human errors: models and management." British Medical Journal. March 18, 2000, 320(7237): 768-70 Rozich, J.D., Haraden, C.R., Resar, R.K. (2003) Adverse drug event trigger tool: a practice methodology for measuring medication related harm. British Medical Journal Publishing Group and Institute for Healthcare Improvement. Rozich, J.D., Resar, R.K., et. al. Standardization as a mechanism to improve safety in health care: impact of sliding scale insulin protocol and reconciliation of medication initiatives. Joint Commission Journal on Quality and Safety. 2004 Womack, J., Jones, D., and Roos, D. (1990). The Machine that Changed the World. The Story of Lean Production. Zimmerman, B. , Lindberg, C., Plsek, P. ( 1998) Edgeware Insights from Complexity Science for Health Care Leaders.en_GB
dc.date.available2011-10-28T15:48:55Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:48:55Z-
dc.conference.date2006en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationDenver, Colorado, USAen_US
dc.description10th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 4-6 October, 2006 at the Colorado Convention Center in Denver, Colorado, USA.en_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.-
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