Introduction
Medical reconciliation is an effective way to improve patient outcomes and reduce the number of hospitalizations in American hospitals. However, it is not enough to introduce this idea and prove that it will work in any medical setting. The application of a thoughtful implementation plan and the evaluation of the outcomes and potential barriers are required to ensure that the offered evidence-based practice (EBP) is appropriate for patients and the staff.
Applicable Change
There are many ways to introduce medication reconciliation implementation in modern hospitals. Its effectiveness is observed in adult and pediatric populations when the list of current and newly prescribed medications is developed and compared to communicate appropriate patient recommendations (McDonald et al., 2018). However, nurses should be well-prepared for cooperation and communication with patients, and their level of knowledge is the goal of the application change (Mardani et al., 2020). The medical staff should focus on their education and take training sessions about medication reconciliation to reduce hospital readmission.
Implementation Plan and Outcome Measures
The offered intervention will be implemented in two major phases, including two steps each. The outcomes will be properly measured as soon as the four steps are taken. The first part of this implementation plan is evaluating individuals’ knowledge and education of nurses. Nurses and patients will be asked what they know about medication reconciliation and the conditions when this step is critical. Then, weekly educative sessions will be introduced during the next two months. At this moment, the first phase of the implementation is over. The second phase includes nurse-patient communication, sharing knowledge, and promoting medication reconciliation. The expected outcome measures are reduced hospital readmissions, increased patient awareness (correct answers to the questions), and high nurse collaborative skills.
Evidence-Based Practice Impact
Education about medication reconciliation is highly promoted in many studies. Mardani et al. (2020) support the idea of two-month education sessions, and McDonald et al. (2018) explain the worth of medication reconciliation optimization in the pediatric emergency department. Some researchers admit that medication reconciliation should be taken together with other interventions like structured discharge or proactive roles of pharmacists (Domingo et al., 2021; Ensing et al., 2015, as cited in Anderson et al., 2019). Poor training and weak staff support are the possible barriers to helping patients maintain their health and avoid hospitalizations after discharge (Redmond et al., 2020). Therefore, these EBP ideas were used as a solid background in creating the intervention plan.
Evaluation of the Nursing Intervention
The evaluation of the nursing intervention should touch upon three aspects – nurses’ knowledge, patient awareness, and the number of hospital readmissions after medication reconciliation. The comparison of nurses’ and patients’ answers before and after the intervention will show if education and training are effective. If there are other factors that might contribute to positive or negative changes, they should be reported for further examination. The control of hospital readmission rates will be the major evaluation element in this plan.
Potential Barriers and Solutions
Despite the intention to properly plan each step, some problems cannot be avoided. Nursing shortage and workload remain the two challenges for many nurses. Therefore, managing time or inviting all nurses for a training course is not always possible. These obstacles can be solved by additional communication with nurses, the choice of free dates, the reduction of sessions up to one per week, and cooperation with hospital administrators.
Conclusion
Medication reconciliation is a good solution for nurses to reduce the number of hospital readmissions. Education for nurses is the intervention that should help the participants increase their knowledge on this topic and learn how to share this experience with others. As soon as people understand the benefits and importance of this step in their treatment, there is a chance to achieve the desired outcome and improve human well-being.
References
Anderson, L. J., Schnipper, J. L., Nuckols, T. K., Shane, R., Le, M. M., Robbins, K., & Pevnick, J. M. (2019). Effect of medication reconciliation interventions on outcomes: A systematic overview of systematic reviews. American Journal of Health-System Pharmacy, 76(24), 2028-2040.
McDonald, D., Mansukhani, R., Kokotajlo, S., Diaz, F., & Robinson, C. (2018). Effect of nursing education on optimization of medication reconciliation in the pediatric emergency department. The Journal of Pediatric Pharmacology and Therapeutics, 23(3), 203-208.
Mardani, A., Griffiths, P., & Vaismoradi, M. (2020). The role of the nurse in the management of medicines during transitional care: A systematic review. Journal of Multidisciplinary Healthcare, 13, 1347-1361.
Redmond, P., Munir, K., Alabi, O., Grimes, T., Clyne, B., Hughes, C., & Fahey, T. (2020). Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – A qualitative study. BMC Family Practice, 21(1), 1-10.