ISMP Survey on Medication Reconciliation

Home care Total: 66
About you
1. What is your profession?
Nurse 70%
Other 11%
Pharmacist 12%
Physician/prescriber 8%
2. What is your staffing level?
Administrator 14%
Manager 27%
Other 15%
Staff 44%
3. Are you familiar with the JC NPSG related to medication reconciliation? 88% - Yes 12% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 62% - Yes 38% - No
About your facility
5. In what type of facility are you employed?
Home care 100%
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 11%
3-6 months 15%
6-12 months 20%
Don’t know 9%
More than a year 38%
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 12%
1-3 months 14%
3-6 months 17%
6-12 months 17%
Don’t know 20%
More than a year 20%
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 12%
1-3 months 8%
3-6 months 11%
6-12 months 18%
Don’t know 15%
More than a year 36%
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 61% 8% 5% 0% 11% 0%
b. Assuring the medication history is accurate 59% 12% 12% 0% 8% 0%
c. Reconciling medications between the history and the admission orders 59% 12% 8% 2% 8% 0%
d. Reconciling medications upon transfer of a patient to another level of care 56% 8% 5% 0% 6% 3%
e. Reconciling medications at the time of discharge 56% 8% 8% 0% 5% 3%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 45% 2% 2% 9% 11% 6%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 9%
24 17%
36 8%
48 14%
Not Sure 26%
Other 26%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 49%
Not Sure 24%
Yes 27%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 23%
Computer charting system 29%
Not documented 12%
Not sure 6%
Paper chart 30%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 15%
Never 61%
Not Sure 11%
Sometimes 14%
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 45%
2 15%
3 11%
4 11%
5 3%
6 8%
7 3%
8 3%
i. Unreliable patient
1 39%
2 16%
3 13%
4 10%
5 10%
6 8%
7 3%
8 2%
ii. Clearly defined protocols
1 23%
2 27%
3 16%
4 15%
5 8%
6 5%
7 3%
8 3%
ii. Documentation from other sources
1 29%
2 21%
3 5%
4 13%
5 6%
6 10%
7 8%
8 8%
iii. Centralized history form/screen
1 19%
2 23%
3 15%
4 11%
5 10%
6 5%
7 15%
8 3%
iii. Lack of teamwork among disciplines
1 23%
2 24%
3 15%
4 11%
5 13%
6 5%
7 5%
8 5%
iv. History collection by pharmacist
1 6%
2 5%
3 13%
4 13%
5 10%
6 10%
7 15%
8 29%
iv. Extra burden
1 16%
2 5%
3 11%
4 15%
5 18%
6 11%
7 13%
8 10%
v. Easy communication with outpatient providers
1 32%
2 21%
3 11%
4 13%
5 5%
6 6%
7 6%
8 5%
v. Lack of frontline staff input into process
1 13%
2 15%
3 8%
4 15%
5 11%
6 13%
7 13%
8 13%
vi. Reasonable expectations for “complete” history
1 24%
2 21%
3 15%
4 11%
5 5%
6 11%
7 10%
8 3%
vi. Lack of administrative leadership 
1 18%
2 6%
3 10%
4 13%
5 13%
6 19%
7 11%
8 10%
vii. Awareness of the role of each contributor
1 24%
2 21%
3 13%
4 6%
5 5%
6 13%
7 13%
8 5%
vii. Lack of physician leadership
1 21%
2 13%
3 15%
4 8%
5 10%
6 11%
7 6%
8 16%
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 2%

2 5%

3 12%

4 12%
5 68%

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