Abstract
Background: Medication reconciliation is a critical component of hospital admission, reducing medication errors, improving patient safety, and ensuring continuity of care.1–3 Uncertainty persists over which healthcare providers (i.e., nurses, pharmacists, physicians) are primarily responsible for performing medication reconciliation when patients are admitted from the emergency department (ED).4 Understanding frontline nurses’ perspectives about medication reconciliation is key to informing practice improvements and patient outcomes.
Purpose: This project aimed to identify nurses' perspectives about current medication reconciliation practices including responsibility, barriers, and solutions to enhance safety, workflow efficiency, and interprofessional collaboration.
Methods: Guided by the Plan Do Study Act framework5, a literature search identified evidence surrounding health care workers performing medication reconciliation in the ED. An electronic survey was distributed to ED, med-surg, progressive, and intensive care nurses at a 150-bed Midwest hospital. The 17-item Likert-scale survey assessed perceptions of process effectiveness, role clarity, accuracy, and barriers. Data were collected over two weeks in February 2025 via Google Forms and analyzed in Excel for frequencies and trends.
Results: Fifty nurses completed the survey (n=11 ED, n=39 inpatient units). Nearly half 48% (24/50) reported the current process for verifying home medications was ineffective. Common barriers were time constraints (82%, 41/50) and incomplete information (46%, 23/50). Perspectives on responsibility were divided, as 38% (19/50) agreed or strongly agreed that nurses on inpatient units should verify home medications, while 48% (24/50) agreed or strongly agreed that ED nurses should be responsible for the task. Pharmacist involvement and a dedicated medication reconciliation team were identified as potential process improvements.
Conclusion: Role ambiguity and system inefficiencies underscore the need for clear role definition and standardized workflows. Future investigations should focus on enhanced training, pharmacist integration, and strengthened interprofessional collaboration.4 Next steps include policy development to establish accountability and piloting standardized protocols to improve accuracy and patient safety.
Notes
Presenter notes available in attached slide deck.
References:
1. Alghamdi DS, Alhrasen M, Kassem A, et al. Implementation of medication reconciliation at admission and discharge in Ministry of Defense Health Services hospitals: study. BMJ Open Qual. 2023;12(2):e002121. doi:10.1136/bmjoq-2022-002121
2. Arrison W, Merritt E, Powell A. Comparing medication histories obtained by pharmacy technicians and nursing staff in the emergency department. Res Social Adm Pharm. 2020;16(10):1398-1400. doi:10.1016/j.sapharm.2020.01.009
3. Choi YJ, Kim H. Effect of pharmacy led medication reconciliation in emergency departments: A systematic review and meta analysis. J Clin Pharm Ther. 2019;44(6):932-945. doi:10.1111/jcpt.13019
4. Lee KP, Hartridge C, Corbett K, Vittinghoff E, Auerbach AD. “Whose job is it, really?” Physicians’, nurses’ and pharmacists’ perspectives on completing inpatient medication reconciliation. J Hosp Med. 2015;10(3):184-186. doi:10.1002/jhm.2289
5. Agency for Healthcare Research and Quality. Plan-Do-Study-Act Worksheet, Directions, and Examples. US Department of Health & Human Resources. Published online March 2024. https://www.ahrq.gov/health-literacy/improve/precautions/tool2b.html
Sigma Membership
Gamma Pi at-Large
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Quality Improvement
Research Approach
Other
Keywords:
Medication Reconciliation, Acute Care, Interprofessional Relations, Medication Errors--Prevention and Control, Nurse Attitudes, Nurse Attitudes--Evaluation, Emergency Department, Emergency Room, Emergency Service
Recommended Citation
Loecker, Courtney N.; Gaver, Lori; Brooks, Jadyn; Hanus, Monica; and Smart, Ally, "Medication Reconciliation in the Emergency Department: Whose job is it?" (2026). Creating Healthy Work Environments (CHWE). 53.
https://www.sigmarepository.org/chwe/2026/presentations_2026/53
Conference Name
Creating Healthy Work Environments
Conference Host
Sigma Theta Tau International
Conference Location
Washington, DC, USA
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-04-29
Medication Reconciliation in the Emergency Department: Whose job is it?
Washington, DC, USA
Background: Medication reconciliation is a critical component of hospital admission, reducing medication errors, improving patient safety, and ensuring continuity of care.1–3 Uncertainty persists over which healthcare providers (i.e., nurses, pharmacists, physicians) are primarily responsible for performing medication reconciliation when patients are admitted from the emergency department (ED).4 Understanding frontline nurses’ perspectives about medication reconciliation is key to informing practice improvements and patient outcomes.
Purpose: This project aimed to identify nurses' perspectives about current medication reconciliation practices including responsibility, barriers, and solutions to enhance safety, workflow efficiency, and interprofessional collaboration.
Methods: Guided by the Plan Do Study Act framework5, a literature search identified evidence surrounding health care workers performing medication reconciliation in the ED. An electronic survey was distributed to ED, med-surg, progressive, and intensive care nurses at a 150-bed Midwest hospital. The 17-item Likert-scale survey assessed perceptions of process effectiveness, role clarity, accuracy, and barriers. Data were collected over two weeks in February 2025 via Google Forms and analyzed in Excel for frequencies and trends.
Results: Fifty nurses completed the survey (n=11 ED, n=39 inpatient units). Nearly half 48% (24/50) reported the current process for verifying home medications was ineffective. Common barriers were time constraints (82%, 41/50) and incomplete information (46%, 23/50). Perspectives on responsibility were divided, as 38% (19/50) agreed or strongly agreed that nurses on inpatient units should verify home medications, while 48% (24/50) agreed or strongly agreed that ED nurses should be responsible for the task. Pharmacist involvement and a dedicated medication reconciliation team were identified as potential process improvements.
Conclusion: Role ambiguity and system inefficiencies underscore the need for clear role definition and standardized workflows. Future investigations should focus on enhanced training, pharmacist integration, and strengthened interprofessional collaboration.4 Next steps include policy development to establish accountability and piloting standardized protocols to improve accuracy and patient safety.
Description
This quality improvement project describes insights into nurses’ perspectives on medication reconciliation, uncovering barriers, role ambiguity, and opportunities for innovation. Findings highlight the importance of strategies to enhance interprofessional collaboration, establish role clarity, and implement standardized processes that improve workflow efficiency and advance patient safety.