ISMP Survey on Medication Reconciliation

Staff Total: 3046
About you
1. What is your profession?
Nurse 96%
Other 1%
Pharmacist 2%
Physician/prescriber 0%
2. What is your staffing level?
Staff 100%
3. Are you familiar with the JC NPSG related to medication reconciliation? 14% - Yes 86% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 9% - Yes 91% - No
About your facility
5. In what type of facility are you employed?
Assisted living 0%
Home care 1%
Hospital 97%
Long term care 0%
Other 1%
Outpatient/office-based facility 1%
Surgery center 0%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 83%
1-3 months 3%
3-6 months 4%
6-12 months 3%
Don’t know 4%
More than a year 3%
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 84%
1-3 months 3%
3-6 months 3%
6-12 months 3%
Don’t know 4%
More than a year 3%
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 84%
1-3 months 3%
3-6 months 3%
6-12 months 2%
Don’t know 5%
More than a year 3%
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 17% 3% 8% 2% 2% 2%
b. Assuring the medication history is accurate 16% 5% 9% 2% 3% 3%
c. Reconciling medications between the history and the admission orders 14% 6% 9% 2% 2% 3%
d. Reconciling medications upon transfer of a patient to another level of care 14% 5% 9% 2% 2% 4%
e. Reconciling medications at the time of discharge 14% 4% 10% 2% 2% 4%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 10% 3% 5% 3% 3% 7%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 84%
24 6%
36 0%
48 0%
Not Sure 8%
Other 1%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 89%
Not Sure 9%
Yes 2%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 4%
Computer charting system 3%
Not documented 1%
Not sure 2%
Paper chart 91%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 87%
Never 8%
Not Sure 2%
Sometimes 3%
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 92%
2 3%
3 2%
4 1%
5 1%
6 1%
7 0%
8 1%
i. Unreliable patient
1 91%
2 3%
3 2%
4 1%
5 1%
6 1%
7 1%
8 1%
ii. Clearly defined protocols
1 89%
2 4%
3 2%
4 1%
5 1%
6 1%
7 1%
8 1%
ii. Documentation from other sources
1 87%
2 3%
3 2%
4 2%
5 2%
6 1%
7 1%
8 1%
iii. Centralized history form/screen
1 89%
2 3%
3 3%
4 2%
5 1%
6 1%
7 1%
8 1%
iii. Lack of teamwork among disciplines
1 88%
2 3%
3 3%
4 2%
5 1%
6 1%
7 1%
8 1%
iv. History collection by pharmacist
1 86%
2 1%
3 2%
4 2%
5 2%
6 2%
7 3%
8 3%
iv. Extra burden
1 86%
2 3%
3 2%
4 2%
5 2%
6 1%
7 2%
8 1%
v. Easy communication with outpatient providers
1 86%
2 2%
3 2%
4 2%
5 2%
6 2%
7 2%
8 1%
v. Lack of frontline staff input into process
1 87%
2 2%
3 2%
4 2%
5 2%
6 2%
7 1%
8 1%
vi. Reasonable expectations for “complete” history
1 88%
2 3%
3 2%
4 2%
5 2%
6 2%
7 1%
8 1%
vi. Lack of administrative leadership 
1 86%
2 2%
3 2%
4 2%
5 2%
6 2%
7 2%
8 1%
vii. Awareness of the role of each contributor
1 87%
2 3%
3 2%
4 2%
5 2%
6 2%
7 2%
8 1%
vii. Lack of physician leadership
1 87%
2 2%
3 2%
4 2%
5 2%
6 2%
7 2%
8 1%
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 1%

2 85%

3 2%

4 3%
5 9%

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