Challenges in obtaining accurate home medication lists in emergency triage at an academic medical center: Perceptions from nurses

The goal of this project was to assess perceptions of medication reconciliation from health care professionals who perform this task. Specific areas of interest included the perceived amount of time spent on medication reconciliation; process complexity; and effectiveness of the current process. Opinions concerning the use of alternative processes were also solicited. This prospective qualitative study involved 4 focus group sessions at a tertiary referral teaching hospital in Tucson, AZ. Nurses involved in admission medication reconciliation in the emergency department were invited to participate, and their perceptions were categorized and summarized. Participants reported a range of times to complete the medication reconciliation from zero to more than 20 min. According to the participants, the time spent on each patient depended on patient's medication knowledge and the complexity of the regimens. Participants wanted the medication list entry screen to be easier to use, and they also suggested patient medication lists from previous visits and from outpatient clinics associated with the medical center be easily accessible. Participants felt that emergency triage may not be the most ideal time in which to perform medication reconciliation, and they expressed concerns about accuracy of these medication lists. Whereas some were interested in the possibility of using a patient medication database and expected that it would improve accuracy and save time, others were less open to a perceived additional step. Participants provided suggestions for changes in the current medication reconciliation process that they feel could improve patient satisfaction and increase efficiency.