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Date Available
5-1-2026
Year of Publication
2026
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
College
Nursing
Department/School/Program
Nursing
Faculty
Dr. Candice Falls
Committee Member
Dr. Melissa Czarapata
Faculty
Dr. Jill Clemmons
Abstract
Background: Medication reconciliation (MR) reduces medication errors during care transitions; however, unintentional medication discrepancies (UMDs) remain common due to variable practices and lack of standardization. Patients undergoing elective cardiac procedures are particularly vulnerable given complex medication regimens.
Purpose: This quality improvement project evaluated implementation of a Medication Reconciliation Barrier Identification Checklist (MRBIC) in the cardiac catheterization laboratory to identify patient, staff, and system-level contributors to UMDs.
Methods: A quasi-experimental pre–post design was conducted at a large academic medical center. During a six-week intervention, nurses and providers completed the MRBIC during pre-procedure MR. Barrier scores were compared with the number and type of UMDs per encounter. Discrepancy data were compared with a six-week pre-intervention period. Pre-post intervention surveys assessed staff satisfaction, workflow efficiency, and confidence.
Results: Fifty-one encounters were included in each group. Patients demonstrated high comorbidity burden and polypharmacy. MRBIC implementation improved detection of UMDs and increased staff-reported confidence, workflow efficiency, and satisfaction. No significant correlation was found between cumulative barrier scores and discrepancies. Annual data showed increased discrepancies in 2025 versus 2024, likely reflecting improved identification. Common system-level barriers included time constraints and limited access to external pharmacy records.
Conclusion: The MRBIC supported standardized barrier assessment and improved identification of UMDs, enhancing medication safety. Ongoing challenges highlight the need for workflow optimization, improved access to external records, and potential pharmacy support to sustain improvements.
Recommended Citation
Turner, Julie M., "Unintentional Medication Discrepancies in Outpatient Cardiac Procedures: Identifying Modifiable Barriers" (2026). DNP Projects. 518.
https://uknowledge.uky.edu/dnp_etds/518
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