Date of Degree

12-2019

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Holly B. Cassells

Advisor

Danielle Stramandi

Abstract

Improving medication management has become the 3rd National Patient Safety Goal. Medication errors cost $42 billion annually. A 5-month quality improvement project was conducted in a primary care clinic located in a south Texas metropolitan city to address medication reconciliation problems. The project improved medication management by implementing 7 tools to decrease preventable medication errors: One Source Medication List, staff knowledge pre- and post-tests, visual signs and staff badges, staff templates, Beers Criteria pocket guide, patient brochure, and a quality improvement tracking form. There were two objectives: 1. Staff would improve medication reconciliation documentation by 50%. 2. For patients 65 years of age and older, potential contraindicated medications review using the Beers Criteria medication list to reduce adverse drug events, drug interactions, and allergies would increase by 50%. Objective 1 was not met, achieving only 30%, and Objective 2 reached only 29%, indicating that medication reconciliation continues to be a challenge in that clinic. The implications for practice are for doctorally-prepared nurse practitioners to lead the improvement of medication management by implementing robust medication reconciliation processes, to increase the knowledge and motivation of the staff, and to advocate for a more current medical record software. Therefore, nurse practitioners can help increase patient safety and the outcomes of prescribing practices by providers whose clinical decisions must rely on accurate medication information.

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