Discussion: Capstone Project: Strategic Planning Tool

Statement of Need or Statement of Problem to Be Addressed

Within Medilodge, a skilled nursing facility, there lacks an efficient and thorough process for reviewing and confirming medications with patients, families, and physicians following the transition of care. This deficit highlights the need for a comprehensive protocol reform to be implemented to combat the growing transition of care medication errors and subsequent readmission to hospitals.

Background of the Problem

(minimum of three scholarly sources current within the last five years)

"Transition of care from hospital to primary care has been associated with increased medication errors, with an estimate of 60% of medication errors occurring during times of transition" (Kee et al., 2018, p.501).

The process of a medication review consists of reviewing a prior medication list to a current medication list to ensure an accurate list has been generated (Chiewchantanakit et al., 2020).

During the transition of care, healthcare professionals, patients, and their families must undertake the vital medication review process (Hahn-Goldberg et al., 2021). This review period allows patients and their families to review medications and verify that it reflects the current plan of care (Hahn-Goldberg et al., 2021).

This study shows that 16% of the readmissions are caused by medication and that 40% of these are potentially preventable. Most of the medication errors involved in the potentially preventable readmissions were classified as non-adherence (35%) and prescribing errors (35%), followed by transition errors (30%) (Uitvlugt et al., 2021, p.6).

Desired outcome of the capstone project

Related activities to facilitate the stated outcome

Timeline for implementation of stated activities

Evaluation plan (corresponding to the stated outcome)

95% of Medilodge nursing staff will adhere to the reformed patient-centered medication reconciliation protocol to increase patient safety and awareness of their treatment plan by the end of October 2022.

Formulate and submit an updated medication reconciliation protocol for staff utilizing a three-check method. Similar to the three checks utilized in medication administration.

Verifying medication with reporting nurse

Verifying medications with a second nurse upon entry

Reviewing medications ordered with the patient and or family member.

Verifying medications with physician addressing any discrepancies identified including those by the patient and or family.

Obtaining signatures of medications ordered by two nurses and patient (if able) or family member.

Supply patients and or family member (POA/Guardian) with a copy of verified medications.

Obtain approval from facility by September 2nd, 2022.

Evaluation will begin with managers reviewing competency sign offs of the implemented inservice educating staff on the new protocol.

Hall managers will monitor admissions for three signatures on medication orders (or two nurses signing off for over the phone reviews with family) during admission reviews.

The goal will be met when 95% of Medilodge licensed nursing staff adhere to the updated medication reconciliation protocol which will be evident through medication order signatures.

Submit a written in-service to management for approval addressing the new medication reconciliation protocol for all licensed nursing staff to read over explaining the new protocol (listed above) and rationale for all admitting patients.

September 6th, 2022

Launch approved inservice to all staff regarding updated medication reconciliation protocol for admissions.

September 8th, 2022

Launch updated medication reconciliation protocol within the admission packet.

Implement by September 12th, 2022

Monitor compliance of new medication review protocol. By auditing all admissions following implementation of new medication reconciliation protocol for three signatures on medication orders. Providing one-on-one education to those who are noncompliant.

September 13th, 2022-ongoing