Applying the Medications at Transitions and Clinical Handoffs Toolkit in a Rural Primary Care Clinic: Implications for Nursing, Patients, and Caregivers.
Traci Jarrett, Jill Cochran, Adam Baus
PMID 32433146WHAT IT FOUND
Nurses in a rural clinic found 40% of charted medication lists inaccurate or incomplete.
A check-in medication map surfaced over-the-counter and as-needed drugs, but added intake time.
Key findings
01A chart audit of 38 charts found 40% had inaccurate or incomplete medication lists, including 3% with a previously unrecorded as-needed medication and 82% with a previously unrecorded over-the-counter medication.
02Interviewed older adults and caregivers reported confusion organizing multiple medications, changing dosage, timing, and supplements, while many relied on family to track medications.
03Nurses were the primary source of medication reconciliation communication directly with patients and caregivers and worked with providers to create accurate active medication lists.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single rural clinic pilot with no control group, so it cannot show that the process caused better medication reconciliation or fewer readmissions. The hospital dropped out, so transitions from hospital to clinic and readmission outcomes were not measured. The accuracy gain was judged by the team's own definition of an accurate medication list, not by a validated external standard. The intervention was a bundle of printed lists, a yellow form, staff training, an assistant, and prompt questions, so the contribution of any single component cannot be separated. Sample sizes were small: 38 charts audited and 21 patients or caregivers interviewed, and the chart audit covered only one provider's adult population. Patients had to self-identify that a visit followed hospital discharge, which may have missed some transition-of-care patients.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read this as proof that the medication map improves patient safety or reduces readmissions. The study was a small single-clinic pilot, hospital readmission outcomes could not be assessed, and the accuracy gain was judged by the team's own definition rather than a validated outcome.