ISMP Survey on Medication Reconciliation

Other Total: 52
About you
1. What is your profession?
Nurse 52%
Other 21%
Pharmacist 15%
Physician/prescriber 12%
2. What is your staffing level?
Administrator 27%
Manager 25%
Other 17%
Staff 31%
3. Are you familiar with the JC NPSG related to medication reconciliation? 64% - Yes 36% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 29% - Yes 71% - No
About your facility
5. In what type of facility are you employed?
Other 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 31%
1-3 months 16%
3-6 months 4%
6-12 months 14%
Don’t know 22%
More than a year 12%
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 18%
1-3 months 22%
3-6 months 8%
6-12 months 16%
Don’t know 22%
More than a year 12%
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 24%
1-3 months 12%
3-6 months 6%
6-12 months 14%
Don’t know 29%
More than a year 14%
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 38% 0% 8% 0% 8% 4%
b. Assuring the medication history is accurate 29% 2% 13% 2% 0% 8%
c. Reconciling medications between the history and the admission orders 33% 10% 12% 0% 4% 4%
d. Reconciling medications upon transfer of a patient to another level of care 33% 2% 12% 0% 4% 6%
e. Reconciling medications at the time of discharge 37% 2% 10% 0% 4% 4%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 29% 2% 4% 4% 4% 10%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 13%
24 17%
36 11%
48 11%
Not Sure 30%
Other 19%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 37%
Not Sure 42%
Yes 21%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 28%
Computer charting system 17%
Not documented 15%
Not sure 9%
Paper chart 32%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 19%
Never 34%
Not Sure 23%
Sometimes 23%
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 26%
2 17%
3 17%
4 9%
5 7%
6 9%
7 7%
8 9%
i. Unreliable patient
1 36%
2 11%
3 16%
4 9%
5 9%
6 4%
7 11%
8 4%
ii. Clearly defined protocols
1 22%
2 16%
3 4%
4 11%
5 9%
6 11%
7 7%
8 20%
ii. Documentation from other sources
1 27%
2 13%
3 11%
4 13%
5 11%
6 9%
7 11%
8 4%
iii. Centralized history form/screen
1 20%
2 16%
3 16%
4 4%
5 16%
6 13%
7 13%
8 2%
iii. Lack of teamwork among disciplines
1 24%
2 7%
3 16%
4 16%
5 13%
6 13%
7 7%
8 4%
iv. History collection by pharmacist
1 7%
2 9%
3 11%
4 11%
5 13%
6 13%
7 16%
8 20%
iv. Extra burden
1 20%
2 9%
3 11%
4 16%
5 25%
6 5%
7 7%
8 7%
v. Easy communication with outpatient providers
1 24%
2 13%
3 2%
4 18%
5 16%
6 9%
7 4%
8 13%
v. Lack of frontline staff input into process
1 13%
2 22%
3 16%
4 20%
5 9%
6 11%
7 4%
8 4%
vi. Reasonable expectations for “complete” history
1 23%
2 7%
3 18%
4 18%
5 2%
6 18%
7 7%
8 7%
vi. Lack of administrative leadership 
1 16%
2 22%
3 18%
4 7%
5 9%
6 13%
7 7%
8 9%
vii. Awareness of the role of each contributor
1 13%
2 22%
3 7%
4 13%
5 18%
6 13%
7 7%
8 7%
vii. Lack of physician leadership
1 18%
2 22%
3 7%
4 11%
5 2%
6 9%
7 13%
8 18%
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 5%

4 10%
5 86%

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