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Getting to Complete and Accurate Medication Lists During the Transition to Home Health Care
Claire Champion1, Paulina S Sockolow2, Kathryn H Bowles3
1Department of Health Promotion and Development, University of Pittsburgh School of Nursing, Pittsburgh, PA.
Journal of the American Medical Directors Association
|July 30, 2020
Summary
Home health care nurses perform medication reconciliation to ensure patient safety. Improved electronic health record interoperability reduced necessary medication changes, but further enhancements are needed for seamless care transitions.
Area of Science:
- Healthcare Informatics
- Patient Safety
- Nursing Practice
Background:
- Medication reconciliation is critical during care transitions to prevent errors.
- Home health care (HHC) admission nurses face challenges reconciling complex medication regimens.
- Electronic health record (EHR) interoperability impacts the efficiency of medication reconciliation.
Purpose of the Study:
- To characterize medication reconciliation tasks performed by HHC admission nurses.
- To explore the impact of EHR interoperability on medication reconciliation.
- To identify opportunities for improving medication reconciliation during transitions to HHC.
Main Methods:
- An observational field study was conducted across three diverse HHC agencies.
- Researchers observed nurses reconciling medications for 36 patients.
- Medication changes and provider calls were documented to assess reconciliation efforts.
Main Results:
- Patients were often on high-risk polypharmacy (average >12 medications).
- Medication lists required changes for 41% of patients.
- Nurses using interoperable EHR systems made fewer medication list changes.
Conclusions:
- Nurses' efforts in medication reconciliation are essential for patient safety.
- EHR interoperability can streamline medication reconciliation but does not eliminate all discrepancies.
- Enhancing interoperability and care transition processes is crucial for HHC agencies.
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