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CU College of Nursing - Research Stories

College of Nursing

Medication Reconciliation Rate Increases Dramatically at CU's Seniors Clinic

Doctoral work educates, informs

Medication Reconciliation

A deep love for her grandparents led Maria Vejar into caring for the elderly. “My grandparents inspired me,” she recalls. “They were very active and had a wonderful sense of humor. They loved living.” Observing how her grandparents aged and dealt with their medical needs—as well as the quality of care her mother modeled as a nurse—led Vejar to prefer the senior population.

Vejar has been a certified geriatric nurse practitioner since 1997, has worked in CU’s Seniors Clinic for 11 years and is a full-time senior instructor in the CU’s School of Medicine. Now she’s about to complete requirements for her doctor of nursing practice (DNP) degree.

Her doctoral work includes a research project on medication reconciliation and management. It addresses the real problem of exactly what prescribed and over-the-counter medications seniors are taking and how those meds interact with each other in the elderly body. In fact, most clinics have not done a good job of tracking drug intake because it takes time to identify and record drug use. Vejar’s goal was to move the clinic from 64 percent medication reconciliation (that is, a fully reconciled medication list at each clinic visit) to 90 percent or above.

In nine months, the rate rose to 96 percent reconciliation. One benefit to the improvement: by asking patients to bring in all medications, including OTC drugs, patients increased their understanding of the role different drugs play in health.

Vejar presented these findings at geriatric grand rounds in March and at her DNP capstone course in May. “Not only were providers and staff educated that we had a problem,” Vejar says, “but we educated the patients as well.”

Why seek a doctorate when she’s already so established in her career? Her boss, Dr. Robert Schwartz who runs the Seniors Clinic, encouraged her. She had family and financial support. As a result, Vejar was surprised to discover “the program ended up changing my focus far more than I thought it would. As nurses, we have a responsibility to advance to the highest degree we can. Not everyone may want a doctorate, but it’s important to advance to the level you are capable of. It raises the bar and makes us better nurses, preceptors and providers.”​