Date of Award

Fall 12-6-2022

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Sheri Jacobson, PhD, RN

Second Advisor

Stephanie D. Carpenter, DNP, RN


Practice Problem: Medication reconciliation (MR) is crucial in care transitions among healthcare facilities. Developing evidence-based discharge planning strategies, improving communication, optimizing electronic health record intelligence interoperability, and stakeholder engagement will promote a better transition process for patients and healthcare providers.

PICOT: The PICOT question that guided this project was: In an urban-based adult skilled nursing facility, how does an evidence-based structured review, and revision of current MR policy and procedures, compared to the existing MR policy, affect the clarity of the process for communication between clinicians during transitions of care over a 10-week review cycle?

Evidence: Fifteen pertinent studies identified include the similarities in nursing homes' discoveries, electronic health record use, and pharmacy participation in MR efforts. The Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals Model (JHNEBP) and the Centers for Disease Control (CDC) Policy Process (POLARIS) Framework were used in appraising the literature and guiding the policy evaluation and recommendations.

Intervention: The three best practice themes include nursing home vulnerability, electronic medication records, and pharmacy participation. A Policy Evaluation Tool was developed to evaluate the current MR policy against best practices criteria found in the evidence.

Outcome: The recommendations were provided to each organization to incorporate into current practice. Policy templates were specific to each healthcare organization, with recommended revisions to current policy and discharge communication workflow, and provided to each organization to incorporate into current practice.

Conclusion: The evaluation was beneficial to ensure the MR process was current and relevant and promoted best-practice methods.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.

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