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Medication reconciliation in SNFs differs for RNs, LPNs

RNs and LPNs in skilled nursing facilities differ in how they identify discrepancies in medication reconciliation, according to a gerontological nursing expert.

Recognizing the distinct differences between RNs and LPNs in this context could lead to fewer medication errors and better patient care, according to the analysis by Amy Vogelsmeier, RN, PhD, GCNS-BC, assistant professor in the Sinclair School of Nursing at the University of Missouri.

Vogelsmeier noted that because pharmacists and physicians often are unavailable, both RNs and LPNs equally are responsible for practices such as medication reconciliation and other activities to coordinate care once patients enter nursing homes.

However, “these staff often varied in how they processed resident transfer information to identify medication order discrepancies,” Voegelsmeier and coauthors wrote. “Patterns of differences were found related to their perceptions about medication reconciliation, as well as their actions when performing the process.

“RN staff were more often focused on resident safety and putting the ‘big picture’ together, whereas LPN staff were more often focused on the administrative assignment and ‘completing the task.'”

In a news release, Vogelsmeier said RNs often are underutilized in nursing homes even though their clinical education and experience give them a greater sense of the “bigger picture,” which leads to better outcomes.

“Right now in the industry, RNs and LPNs often are used interchangeably but inappropriately,” she added. “The solution is not to replace LPNs with RNs but to create collaborative arrangements in which they work together to maximize the skill sets of each to provide the best possible care for patients.”

Vogelsmeier said assigning RNs and LPNs complementary roles that maximize their unique abilities will improve patient care and satisfaction. Additionally, she said offering LPNs enhanced training opportunities may help them build the cognitive skills necessary to work in the current nursing home environment.

“Nursing home care is more complex than it was 10 years ago,” Vogelsmeier said. “People used to move into nursing homes and stay there the rest of their lives, but now they’re using nursing homes to transition between hospitals and their homes. Patients in nursing homes are sicker, and their stays are shorter. That demands better nursing staff coordination of care.”

The study appeared in the Journal of Gerontological Nursing. To access it via subscription or purchase, visit

By | 2012-03-20T00:00:00-04:00 March 20th, 2012|Categories: Uncategorized|0 Comments

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