Nursing

Feature Article

Medication Reconciliation in Nursing Homes: Thematic Differences Between RN and LPN Staff

Amy A. Vogelsmeier, PhD, RN, GCNS-BC; Jill R. Scott-Cawiezell, PhD, RN, FAAN; Ginette A. Pepper, PhD, RN, FAAN

Abstract

The purpose of this qualitative descriptive study was to describe medication reconciliation practices in nursing homes with a specific focus on nursing staff involvement in the process. The study was conducted in eight Midwestern nursing homes and included 46 onsite observations of resident transfers to the nursing home. Informal interviews of nursing staff performing medication reconciliation were conducted during each observation. Findings suggest nursing home nursing staff, including both RN and licensed practical nurse (LPN) staff, were primarily responsible for performing medication reconciliation; however, these staff often varied in how they processed resident transfer information to identify medication order discrepancies. Patterns of differences were found related to their perceptions about medication reconciliation, as well as their actions when performing the process. RN staff were more often focused on resident safety and putting the “big picture” together, whereas LPN staff were more often focused on the administrative assignment and “completing the task.”

AUTHORS

Dr. Vogelsmeier is Assistant Professor and 2009–2011 John A. Hartford Foundation (JAHF) Claire M. Fagin Fellow, University of Missouri-Columbia, Sinclair School of Nursing, Columbia, Missouri; Dr. Scott-Cawiezell is Professor and Associate Dean for Academic Affairs, The University of Iowa College of Nursing, Iowa City, Iowa; and Dr. Pepper is Professor and Associate Dean for Research and PhD Program and Helen Bamberger Colby Endowed Chair in Gerontological Nursing, University of Utah, College of Nursing, Salt Lake City, Utah.

The authors disclose that they have no significant financial interests in any product or class of products discussed directly or indirectly in this activity. This project was funded by the JAHF and the University of Iowa Gerontological Nursing Interventions Research Center (GNIRC). Dr. Vogelsmeier’s institution received payment from the JAHF for fellowship-related travel and provision of equipment; the GNIRC provided funding to Dr. Vogelsmeier’s institution for additional study expenses. Dr. Pepper received payment from the University of Missouri for grant consultation and travel purposes.

Address correspondence to Amy A. Vogelsmeier, PhD, RN, GCNS-BC, Assistant Professor, University of Missouri-Columbia, S314 Sinclair School of Nursing, Columbia, MO 65211; e-mail: .vogelsmeiera@health.missouri.edu

doi: 10.3928/00989134-20111103-05

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