ISMP Survey on Medication Reconciliation

Long term care Total: 45
About you
1. What is your profession?
Nurse 67%
Other 13%
Pharmacist 13%
Physician/prescriber 7%
2. What is your staffing level?
Administrator 20%
Manager 39%
Other 23%
Staff 18%
3. Are you familiar with the JC NPSG related to medication reconciliation? 54% - Yes 46% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 30% - Yes 70% - No
About your facility
5. In what type of facility are you employed?
Long term care 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 16%
1-3 months 9%
3-6 months 9%
6-12 months 9%
Don’t know 25%
More than a year 32%
7. For transfers to a different level of care, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 11%
1-3 months 11%
3-6 months 11%
6-12 months 7%
Don’t know 24%
More than a year 36%
8. For discharges from your care, how long has a medication reconciliation process been in place on your unit/in your department/facility?   
0 months 9%
1-3 months 7%
3-6 months 20%
6-12 months 11%
Don’t know 31%
More than a year 22%
About your process

9. Who is primarily responsible for the following (you may choose more than one category)…

Nurse Pharmacist Physician/ Prescriber Medical Records Other Don’t Know
a. Collecting an initial medication history 56% 16% 27% 2% 2% 0%
b. Assuring the medication history is accurate 53% 11% 29% 2% 2% 2%
c. Reconciling medications between the history and the admission orders 53% 13% 22% 2% 4% 7%
d. Reconciling medications upon transfer of a patient to another level of care 49% 7% 27% 2% 4% 9%
e. Reconciling medications at the time of discharge 56% 7% 27% 2% 2% 4%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 51% 4% 9% 0% 4% 4%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 7%
24 30%
36 5%
48 7%
Not Sure 21%
Other 30%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 52%
Not Sure 33%
Yes 15%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 24%
Computer charting system 11%
Not documented 9%
Not sure 16%
Paper chart 40%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 16%
Never 52%
Not Sure 20%
Sometimes 11%
14. Please rank the relative importance of success factors and barriers encountered during the implementation of the medication reconciliation program at your facility. Scale: 1=most important, 8=least important (use each number once in the ranking process).
a. SUCCESS FACTORS
Rank
b. BARRIERS
Rank
i. Teamwork among disciplines
1 32%
2 5%
3 18%
4 16%
5 7%
6 5%
7 7%
8 11%
i. Unreliable patient
1 23%
2 19%
3 9%
4 16%
5 9%
6 9%
7 7%
8 7%
ii. Clearly defined protocols
1 36%
2 25%
3 9%
4 11%
5 2%
6 5%
7 5%
8 7%
ii. Documentation from other sources
1 27%
2 25%
3 11%
4 7%
5 14%
6 5%
7 2%
8 9%
iii. Centralized history form/screen
1 25%
2 11%
3 7%
4 9%
5 20%
6 11%
7 5%
8 11%
iii. Lack of teamwork among disciplines
1 19%
2 5%
3 35%
4 9%
5 2%
6 9%
7 16%
8 5%
iv. History collection by pharmacist
1 11%
2 11%
3 9%
4 18%
5 16%
6 7%
7 18%
8 9%
iv. Extra burden
1 11%
2 18%
3 11%
4 2%
5 7%
6 5%
7 25%
8 20%
v. Easy communication with outpatient providers
1 9%
2 14%
3 9%
4 14%
5 5%
6 16%
7 18%
8 16%
v. Lack of frontline staff input into process
1 7%
2 26%
3 9%
4 19%
5 16%
6 14%
7 2%
8 7%
vi. Reasonable expectations for “complete” history
1 14%
2 14%
3 18%
4 18%
5 11%
6 16%
7 5%
8 5%
vi. Lack of administrative leadership 
1 19%
2 12%
3 7%
4 21%
5 7%
6 12%
7 14%
8 9%
vii. Awareness of the role of each contributor
1 11%
2 20%
3 7%
4 14%
5 5%
6 9%
7 23%
8 11%
vii. Lack of physician leadership
1 21%
2 9%
3 14%
4 9%
5 16%
6 12%
7 12%
8 7%
15. On a scale of 1 to 5, with 1=not valuable and 5=very valuable, please select a number below indicating your perception of the value of the medication reconciliation process to patient safety overall:

1 4%

2 7%

3 4%

4 15%
5 70%

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