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Ensuring Effective Medication Reconciliation in Home Healthcare

doi: 10.1097/NHH.0000000000000171
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Ensuring Effective Medication Reconciliation in Home Healthcare

TEST INSTRUCTIONS

  • To take the test online, go to our secure Web site at http://www.nursingcenter.com/HHN.
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  • You will receive your CE certificate of earned contact hours and an answer key to review your results. There is no mini- mum passing grade.
  • Registration deadline is October 31, 2016.
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PROVIDER ACCREDITATION

Lippincott Williams & Wilkins, publisher of Home Healthcare Nurse, will award 2.0 contact hours for this continuing nursing education activity.

Lippincott Williams & Wilkins is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.0 contact hours. Lippincott Williams & Wilkins is also an approved provider of continuing nursing education by the District of Columbia and Florida #50-1223. Your certificate is valid in all states.

The ANCC's accreditation status of Lippincott Williams & Wilkins Department of Continuing Education refers only to its continuing nursing educational activities and does not imply Commission on Accreditation approval or endorsement of any commercial product.

CE TEST QUESTIONS

GENERAL PURPOSE: To provide information on the evidence related to medication reconciliation with implications for home healthcare providers.

LEARNING OBJECTIVES: After reading this article and taking this test, you should be able to:

  1. Identify the scope of medication-related problems that occur during care transitions.
  2. Select strategies to enhance medication reconciliation for the home healthcare patient.
  1. Studies estimate that as many as what percentage of patients had at least one medication discrepancy during care transitions from hospital to home?
    1. 63%
    2. 75%
    3. 86%
    4. 94%
  2. Michel and colleagues found that the percentage of discrepancies that had the potential to cause harm to patients was as high as
    1. 43.9%.
    2. 53.2%.
    3. 66.2%.
    4. 74.6%.
  3. Medication reconciliation is the process of comparing a patient's medication prescriptions to all the medications the
    1. patient ever took.
    2. patient has been taking.
    3. provider thinks the patient should take.
    4. provider thinks the patient should not take.
  4. According to The Joint Commission, medication reconciliation should be done at every transition of care in which
    1. new medications are prescribed or existing orders are rewritten.
    2. the patient cannot produce a list of the medications he or she takes.
    3. the provider and the patient disagree about the necessity of medications.
    4. hospitalization resulted in heightened awareness about the risks of taking medications.
  5. The primary providers responsible for helping patients remain healthy enough for self-care and self-management of their medical conditions are
    1. social workers.
    2. home healthcare providers.
    3. primary care physicians.
    4. pharmacists.
  6. 6. According to Bowles and colleagues, what percentage of heart failure patients did not take an angiotensin-converting enzyme inhibitor?
    1. 36%
    2. 41%
    3. 58%
    4. 64%
  7. In the home healthcare setting, care providers must rely on which of the following as a source of medication information?
    1. Patients
    2. Pharmacists
    3. Medical records
    4. Previous caregivers
  8. Because of regulatory requirements, the focus of medication reconciliation is sometimes on
    1. goal setting.
    2. the purpose of the process.
    3. form completion.
    4. the benefit of the process.
  9. According to the Institute for Healthcare Improvement, lack of role clarity among the home healthcare team can lead to gaps in care, such as unaddressed
    1. quality of life issues.
    2. signs and symptoms.
    3. provider disagreements.
    4. medication discrepancies.
  10. Which of the following team members is primarily responsible for making recommendations about optimizing medication therapy?
    1. Nurses
    2. Pharmacists
    3. Physicians
    4. Physician assistants
  11. Home healthcare clinicians can begin the process of medication reconciliation by
    1. establishing a flowchart with each step of the process.
    2. specifying when the process should be implemented.
    3. providing training for all providers involved in the process.
    4. setting a timeframe for completion of the process.
  12. In addition to the information specified in The Joint Commission's medication reconciliation safety goal, home healthcare providers should document which of the following?
    1. Previous caregivers
    2. Willingness to change
    3. Dietary habits
    4. Family involvement
  13. To calculate the proportion of unreconciled medications, the clinician should
    1. multiply the total number of medications by the number of unreconciled medications.
    2. divide the total number of medications by the number of unreconciled medications.
    3. multiply the number of unreconciled medications by the total number of medications.
    4. divide the number of unreconciled medications by the total number of medications.
  14. Integrating which of the following team members into the medication reconciliation processes has been effective in decreasing hospitalizations from home healthcare settings?
    1. Nurses
    2. Pharmacists
    3. Physicians
    4. Physician assistants
  15. Patient participation in medication reconciliation increases when
    1. patients receive a printout of the reconciled medication list.
    2. family members verify the accuracy of the patient's medication regimen.
    3. patients are knowledgeable about medications' adverse effects.
    4. nurses conduct seminars in the community about medications.
  16. 16. All of the following statements about adoption of the electronic health record (EHR) are accurate except
    1. use of an EHR can enhance communication between home healthcare providers.
    2. the EHR helps clinicians obtain access to outside providers' information.
    3. integrated information in an EHR facilitates effective medication reconciliation practices.
    4. more than half of all home healthcare and hospice agencies have adopted use of the EHR.
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