Date of Award
Spring 3-24-2026
Document Type
Scholarly Project
Degree Name
Doctor of Nursing Practice (DNP)
First Advisor
Dr. Hilary Morgan
Second Advisor
Dr. Dawn Onstott
Abstract
Practice Problem: The practice problem for the primary care facility is the inconsistent completion of medication reconciliation (MR) by primary care providers (PCPs), despite attempts by some providers to compare the clinic medication list with the external records and update the electronic health records (EHR). The absence of a standardized evidence-based practice (EBP) MR protocol has resulted in variable practices and increased risk for medication discrepancies during patient encounters.
PICOT: The PICOT question that guided this project was: In primary care providers (P), how does the Evidence-based practice process redesign and workflow optimization protocol (I) compared to current practice (C) affect provider adherence to evidence-based medication reconciliation practices (O) over the 8-week period (T)?
Evidence: Findings from fourteen high-quality articles support the implementation of standardized, EBP MR processes, demonstrating improvements in medication accuracy, and a decrease in medication discrepancies that contribute to enhanced patient safety.
Intervention: The project intervention incorporated the four core steps of the MR process derived from the MATCH (Medications at Transitions and Clinical Handoffs) Toolkit to enhance and standardize clinical workflow. Full-time providers received targeted education on the MATCH Toolkit and were instructed to complete a paper-based MR form at the start of each patient encounter, with provider sign-off required at each step to confirm completion.
Outcome: The desired improvement in EBP MR practices was not achieved during the intervention period; The project encountered significant organizational and leadership barriers that limited implementation; however, it enhanced provider awareness of EBP MR, underscored the importance of standardized workflows for patient safety and quality outcomes, and identified the need for leadership-supported EHR integration and accountability.
Conclusion: Clinical significance was achieved with this evidence-based MR project, even though the overall goal of improving compliance with the standardized reconciliation process was not met. The project highlighted the critical need for organizational readiness for change, leadership engagement, clear strategies for balancing competing priorities, and flexibility to address unanticipated barriers, such as limited provider participation and challenges with EHR integration.
Recommended Citation
Bregman, O. (2026). Evidence-based Practice Medication Reconciliation Protocol: Process to Increase Adherence to Medication Reconciliation Process. [Doctoral project, University of St Augustine for Health Sciences]. SOAR @ USA: Student Scholarly Projects Collection. https:/doi.org/10.46409/sr.PKGO7139
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This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
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.