ISMP Survey on Medication Reconciliation

Other Total: 280
About you
1. What is your profession?
Nurse 73%
Other 8%
Pharmacist 15%
Physician/prescriber 4%
2. What is your staffing level?
Other 100%
3. Are you familiar with the JC NPSG related to medication reconciliation? 95% - Yes 5% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 84% - Yes 16% - No
About your facility
5. In what type of facility are you employed?
Assisted living 1%
Home care 4%
Hospital 79%
Long term care 4%
Other 3%
Outpatient/office-based facility 5%
Surgery center 5%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 8%
1-3 months 14%
3-6 months 30%
6-12 months 21%
Don’t know 7%
More than a year 21%
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 13%
1-3 months 15%
3-6 months 25%
6-12 months 17%
Don’t know 9%
More than a year 21%
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 14%
1-3 months 16%
3-6 months 22%
6-12 months 18%
Don’t know 11%
More than a year 20%
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 78% 5% 24% 0% 4% 0%
b. Assuring the medication history is accurate 63% 19% 41% 0% 2% 4%
c. Reconciling medications between the history and the admission orders 54% 22% 43% 0% 2% 5%
d. Reconciling medications upon transfer of a patient to another level of care 57% 19% 46% 0% 2% 4%
e. Reconciling medications at the time of discharge 58% 12% 54% 0% 1% 3%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 43% 3% 16% 8% 12% 21%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 8%
24 43%
36 2%
48 4%
Not Sure 28%
Other 15%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 59%
Not Sure 29%
Yes 12%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 27%
Computer charting system 15%
Not documented 3%
Not sure 7%
Paper chart 48%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 36%
Never 39%
Not Sure 9%
Sometimes 16%
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 49%
2 15%
3 13%
4 6%
5 7%
6 4%
7 3%
8 3%
i. Unreliable patient
1 33%
2 18%
3 13%
4 10%
5 7%
6 8%
7 7%
8 5%
ii. Clearly defined protocols
1 39%
2 22%
3 14%
4 11%
5 6%
6 3%
7 4%
8 2%
ii. Documentation from other sources
1 15%
2 20%
3 15%
4 13%
5 9%
6 13%
7 11%
8 4%
iii. Centralized history form/screen
1 28%
2 25%
3 9%
4 13%
5 9%
6 7%
7 5%
8 3%
iii. Lack of teamwork among disciplines
1 30%
2 19%
3 15%
4 14%
5 9%
6 5%
7 5%
8 4%
iv. History collection by pharmacist
1 7%
2 9%
3 9%
4 8%
5 11%
6 13%
7 20%
8 22%
iv. Extra burden
1 21%
2 16%
3 12%
4 13%
5 15%
6 9%
7 10%
8 5%
v. Easy communication with outpatient providers
1 14%
2 10%
3 12%
4 15%
5 11%
6 20%
7 14%
8 4%
v. Lack of frontline staff input into process
1 14%
2 17%
3 18%
4 12%
5 9%
6 11%
7 9%
8 9%
vi. Reasonable expectations for “complete” history
1 20%
2 18%
3 18%
4 15%
5 13%
6 9%
7 4%
8 2%
vi. Lack of administrative leadership 
1 11%
2 15%
3 12%
4 12%
5 12%
6 12%
7 17%
8 9%
vii. Awareness of the role of each contributor
1 20%
2 19%
3 18%
4 11%
5 12%
6 9%
7 7%
8 4%
vii. Lack of physician leadership
1 32%
2 16%
3 10%
4 12%
5 7%
6 9%
7 5%
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 0%

2 4%

3 6%

4 18%
5 71%

Staffing Level Other:

ADR/Med error RPh

CNS

Patient Safety Officer/QM

Clinical Phamacist-Medication Safety

CNS

Director

Educator

APN

Nurse Educator

supervisor

Nursing Practice Coordinator

Clinical NurseSpecialist

Supervisor

Coordinator

JCAHO Coordinator

QM RN3

PI Coordinator

Performance Improvement Coordinator

Clinical Specialist

risk manager

Educator

Education Coordinator

Director

Nurse Informaticist

Clinical Nurse Educator

Educator

Infection Control /Employee Health Coordinator

Education

AVP Quality Services

Educator

NP/admin

Clinical Quality Consultant

CNS

CNS

academic educator

Information Technology

Clinical Educator

Clinical Educator

Informaticist

Orientor

house supervisor

Educator

staff development coordinator

Coordinator

Clinical Pharmacist

Director Acute Care

clinical pharmacist

Clinical Pharmacy Specialist

Educator

Special Projects Coordinator

CNS

Quality Specialist

Project Coordinator

performance improvement coordinator

IS analyst

Med/Surg. Nurse Educator

ICU clinical teacher

IT staff/med safety council chair

Safe Medication Practice

Clinical Informatics

Education Specialist

staff educator

Faculty in School of Nursing

Patient Safety Officer

educator

Project Manager

JCAHO Coordinator

Coordinator

educator

Education Staff

Clinical Nurse Specialist

Performance Improvement

Clincial Resource Nurse

Clinical Pharmacist

Clinical Nurse specialist

Education

Performance Improvement Coordinator

Clinical Nurse Specialist

Educator

Advance Practice Nurse

educator

VP Nursing

Nurse Educator

clinical coordinator ICU / CVICU

Quality Department

Clinical Educator

Clinical Coordinator

Research coordinator

Educator

Clinical Educator

Educator

Clinical Nurse Specialist

Educator

Clinical Nurse Specialist

Chief Quality Officer

Account Manager

Clinical Specialist

Clinical Specialist

PI Coordinator

Nursing Educator

CNS

Med Safety Specialist

Nursing Analyst

Infection Control

Educator

clinical infomatics educator

Specialist Quality Services

Nurse Educator

Clinical Coordinator

Educator

Charge Nurse

CNS

EDucator

Med Rec pharmacist

Clinical Pharmacist

Clinical Nurse Specialist

Charge Nurse

Supervisor

Corporate Accreditation

nurse educator

Quality & Risk Manager

quality

Clinical Quality Specialits

Clinical Nurse Educator

Clinical Nurse Specialist/Educator

Supervisor

Educator

Nurse Quality Analyst

Educator

clinical coordinator

CNS

coordinator

administrative support

Medication Safety Specialist

Clinical Educator

educator

Clinical Educator

Physician Leader Medical Informatics

Cardiothoracic Clinical Liaison

clinical nurse educator

education informatics

Clinical Educator

Medical Management Coord

Critical Care Educator

Performance Improvement Coordiantor

Clincial Research Coordinator

Agency staff PRN

Director

Staff Educator

Clincial Coordinator

Director

Standards Coordinator

Charge RN

QA/QI

Clinical Coordinator

Executive Director

Educator

Care Coordinator

Director of Nurses

Supervisor

educator/staff development

Clinical Nurse Specialist

Supervisor/Quality

charge nurse

Clinical Nurse Specialist

Nurse Educator

Educator

Director

Staff developer

QA coordinator

specialist

Coordinator

Director of Care

Director of Care

Educator

Clinical Coordinator

Director

Charge Nurse, PT Care Coordinator

Educator

Nursing ServicesConsultant

Pharmacist in charge

Staff Development Coordinat

Assistant Nurse

Inpatient Pharmacy Supervisor

Conrad

Osvaldo

CNIV

Nurse Clinician

Misael

Sabastian

Rafael

Rick

Brandan

Efren

Julian

Anibal

Theodore

Skylar

Dexter

Reese

Ryne

Lisandro

Jair

Domingo

Waylon

Sammy

Landen

Layne

Tavion

Chad

Kurtis

Bryce

Nicolas

Deangelo

Arnaldo

Brendan

Brennan

Conner

Zaire

Caden

Federico

Koby

James

Roosevelt

Darren

Ean

Dennis

Maria
Darren

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