ISMP Survey on Medication Reconciliation

Assisted living Total: 30
About you
1. What is your profession?
Nurse 17%
Other 20%
Pharmacist 23%
Physician/prescriber 40%
2. What is your staffing level?
Administrator 27%
Manager 37%
Other 10%
Staff 27%
3. Are you familiar with the JC NPSG related to medication reconciliation? 50% - Yes 50% - No
4. Have you attended inservice education regarding your role in medication reconciliation? 0% - Yes 100% - No
About your facility
5. In what type of facility are you employed?
Assisted living 100%
6. For admissions, how long has a medication reconciliation process been in place on your unit/in your department/facility? 
0 months 10%
1-3 months 7%
3-6 months 20%
6-12 months 17%
Don’t know 23%
More than a year 23%
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 17%
1-3 months 7%
3-6 months 20%
6-12 months 27%
Don’t know 23%
More than a year 7%
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 17%
1-3 months 27%
3-6 months 20%
6-12 months 13%
Don’t know 17%
More than a year 7%
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 3% 3% 3% 0% 3% 0%
b. Assuring the medication history is accurate 3% 0% 3% 0% 3% 0%
c. Reconciling medications between the history and the admission orders 3% 0% 3% 0% 3% 0%
d. Reconciling medications upon transfer of a patient to another level of care 3% 3% 3% 0% 3% 0%
e. Reconciling medications at the time of discharge 3% 0% 3% 0% 3% 0%
f. Sending the patient’s discharge medication list to the patient’s physician/next provider 3% 0% 3% 0% 3% 0%
10. After an admission medication history is obtained, your policy states all medications must be reconciled within how many hours?
12 17%
24 17%
36 7%
48 23%
Not Sure 20%
Other 17%
11. Does your policy specify a different timeframe for reconciliation depending upon the critical nature of the drugs on the medication history list?
No 100%
12. Your medication reconciliation process is documented on which type of form?
Combination of both 23%
Computer charting system 27%
Not documented 23%
Not sure 10%
Paper chart 17%
13. Does the prescriber order medications directly on the same form or screen used to document the initial medication history?
Always 27%
Never 40%
Not Sure 10%
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 17%
2 14%
3 10%
4 14%
5 10%
6 3%
7 14%
8 17%
i. Unreliable patient
1 21%
2 10%
3 14%
4 3%
5 10%
6 14%
7 10%
8 17%
ii. Clearly defined protocols
1 17%
2 17%
3 7%
4 7%
5 7%
6 28%
7 7%
8 10%
ii. Documentation from other sources
1 10%
2 7%
3 14%
4 17%
5 3%
6 14%
7 17%
8 17%
iii. Centralized history form/screen
1 28%
2 17%
3 3%
4 10%
5 14%
6 10%
7 10%
8 7%
iii. Lack of teamwork among disciplines
1 14%
2 10%
3 21%
4 14%
5 7%
6 14%
7 10%
8 10%
iv. History collection by pharmacist
1 17%
2 10%
3 17%
4 7%
5 14%
6 7%
7 3%
8 24%
iv. Extra burden
1 21%
2 3%
3 17%
4 14%
5 7%
6 7%
7 21%
8 10%
v. Easy communication with outpatient providers
1 28%
2 14%
3 7%
4 14%
5 21%
6 7%
7 3%
8 7%
v. Lack of frontline staff input into process
1 10%
2 3%
3 3%
4 21%
5 21%
6 10%
7 10%
8 21%
vi. Reasonable expectations for “complete” history
1 7%
2 14%
3 17%
4 7%
5 17%
6 24%
7 10%
8 3%
vi. Lack of administrative leadership 
1 7%
2 3%
3 17%
4 10%
5 17%
6 10%
7 21%
8 14%
vii. Awareness of the role of each contributor
1 7%
2 21%
3 7%
4 24%
5 10%
7 24%
8 7%
vii. Lack of physician leadership
1 10%
2 17%
3 14%
4 24%
5 14%
6 3%
7 14%
8 3%
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:

2 50%
5 50%

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