Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Holly Cassells


Irene Gilliland


Joseph Martinez O'Hara


The purpose of this quality improvement project was to improve medication management processes for patients in a wellness center. Medication reconciliation is a safe practice shown to reduce the potential for patient harm by preventing prescribing errors and adverse drug effects. Medication reconciliation includes assessment of medications, development of medication lists, education, and medication counseling for patients (Snyderman, Salzman, Mills, Hersh, & Parks, 2014). Assessment of medication reconciliation in a geriatric wellness center revealed poor medication management. Education on medication management was provided to staff (N = 10) and the workflow was altered to improve processes. Electronic medical records of 86 elderly Hispanic patients (mean age = 72.7) were compared before and after the education and the clinic process improvement to assess if documentation, medication reconciliation, patient education, and adverse drugs were addressed. After 6 weeks, 4 improvements were observed: (a) increased rate of staff and provider documentation of patients’ medications in the EMR from 25% to 82%, (b) improved patient reminders to bring medications to the clinic resulting in increased medication recording from 10% to 82%, (c) reduced high-risk medications prescribed from 8% of elderly patients to 5%, and (d) improved the receipt of patient medication education from 0% to 82% of patients. The interventions for staff and providers were effective in improving the practice and processes of medication reconciliation. The leadership of the Doctor of Nursing Advanced Practice Registered Nurse improved medication management and enabled this clinic to reach Medicare performance standards.

Included in

Nursing Commons