Date of Award

Fall 11-16-2022

Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Mary Brann, DNP, RN

Second Advisor

Mary Jane Bowles, DNP, RN, CCRN, CNS-BC


Practice Problem: Medication reconciliations are often completed inadequately or inaccurately when patients are admitted to the hospital. Findings at the study site identified an average of two pharmacy interventions necessary per admitted patient to correct home medication lists after completion of the medication reconciliation.

PICOT: The PICOT question that guided this project was “In adult patients admitted to a 100-bed acute care hospital (P), how does use of the MATCH toolkit for medication reconciliation process steps (I), compared to the current process of home medication reconciliation completed by the physician prior to nursing or pharmacy team review (C) affect accuracy of medication reconciliation (O) within a 6-week time frame?”

Evidence: Choosing a validated tool, such as MATCH (Medications at Transitions and clinical Handoffs) and implementing a consistent process for medication reconciliation using that tool is best practice. It is important to ensure all parties within the healthcare team understand their roles and ownership of the medication reconciliation process.

Intervention: When admitting patients to the hospital, physicians waited for home medication list reviews to be completed by nursing staff prior to completing their medication reconciliation and entering orders for the patient’s home medications. Education was provided to nursing staff regarding home medication list review expectations and tips to facilitate accurate changes to the list.

Outcome: Project data demonstrated a statistically significant relationship between the timing of physicians ordering home medications (waiting for nursing staff to complete their medication list review) and the accuracy of patient discharge medication lists. A linear regression analysis was used.

Conclusion: The purpose of this project was to improve a vital aspect of hospital care with an evidence-based intervention: a dedicated admission medication reconciliation process. This project’s evidence-based change showed a statistically significant relationship between the timing of home medication order entry and accuracy of discharge medication reconciliations; additional data collected provided a basis for continued improvements.


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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