ILE currently working with a partner for my ILE on the topic of Medication reconciliation. It includes a literature review, survey, data analysis along with the training manual which contains all the information- which includes- background, problem statement, methodology, data analysis, suggested improvements and suggestions for patient education regarding medication reconciliation. It should also contain a brochure/flyer for patient medication reconciliation education.
As a part of the requirements criteria, the ILE should contain 2 foundational; 2 concentration competencies. My concentration is Infectious diseases, I was planning to include patient education in association with medication compliance for antibiotics and interruption in patient education which can increase antimicrobial resistance among those with infections.
Also, the ILE patient education component should bring up theories of behavioral theories.
The capstone should have at least 10,000 words and AMA citations. It is mandatory to have citations at end of each sentence for the ones taken from references.
Attached is the capstone document along with the draft of the medication reconciliation literature review that I have done which does not contain citations at end of every sentence as of now, it is still in process of development.
ILE/Capstone Rubric
Competency Integration & Written Communication
Student Name:
ILE Mentor Name:
Project Title:
Date:
Students: Complete an assessment table for each of the 4 competencies you are demonstrating and
synthesizing
through your ILE (2 foundational; 2 concentration), as well as one about the synthesis of competencies in your
ILE document (see 5 pages, below).
**It is highly recommended that each student use this rubric template as a tool in early planning stages in order
to plan for satisfactory demonstration and integration of competencies in their ILE.**
The first draft of this rubric (with all 5 table templates complete) is due in March (see Canvas for date), in
Canvas and to the Faculty Mentor.
Based on feedback from your ILE Mentor (using the First Draft Review Worksheet)), the final draft of your
Competency Defense Rubric is due in April, along with the final draft of your ILE document (see Canvas for
date).
Scoring: After submitting your final draft and rubric, your Mentor will score your ILE document based on (a)
Competency Defense Rubric—4 competencies + synthesis (half of the total score for your ILE, up to 20 points);
and, (b) Written Communication Rubric—5 other elements (half of the total score for your ILE, up to 20
points). You must score at least a 3 for each element (10 elements) to pass the ILE; if you score below a 3 on
any of these elements, you will need to make necessary revisions, no later than the end of the semester exam
period.
Competence: The ability to integrate and apply relevant skill(s) and knowledge.
Complete one for each of 4 competencies.
1 2 3 4 Score and reasoning
Foundational
Competency 1:
To be filled in by
student
Does not address the
knowledge and skills
outlined for this
competency or
effectively apply them
in a real-world setting.
More than one
component-
knowledge, skills,
application- is entirely
missing or incorrect.
Demonstrates some
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-world
setting. More than one
component- knowledge,
skills, application- has
insufficient depth/detail,
contains inaccuracies,
does not effectively
address the real-world
need, or otherwise does
not fully
demonstrate
competence, OR ONE
component is entirely
missing.
Demonstrates
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-
world setting. One
component- knowledge,
skills, OR application-
has insufficient
depth/detail, contains
inaccuracies, does not
effectively address the
real-world need, or
otherwise does not fully
demonstrate
competence.
Demonstrates clear
mastery: detailed
understanding of both
the knowledge and skills
outlined for this
competency, and
effective (appropriate
and sufficient)
application in a real-
world setting.
To be filled in by faculty
Mentor
& Reviewer –
Knowledge demonstrated:
Understanding of…
Skills demonstrated:
How to…
How and Why knowledge & skills are applied in
my project—and where to find in the document:
To be filled in by student – To be filled in by student – To be filled in by student –
Competence: The ability to integrate and apply relevant skill(s) and knowledge.
Complete one for each of 4 competencies.
1 2 3 4 Score and reasoning
Foundational
Competency 2:
To be filled in by
student
Does not address the
knowledge and skills
outlined for this
competency or
effectively apply them
in a real-world setting.
More than one
component-
knowledge, skills,
application- is entirely
missing or incorrect.
Demonstrates some
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-world
setting. More than one
component- knowledge,
skills, application- has
insufficient depth/detail,
contains inaccuracies,
does not effectively
address the real-world
need, or otherwise does
not fully demonstrate
competence, OR ONE
component is entirely
missing.
Demonstrates
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-
world setting. One
component- knowledge,
skills, OR application-
has insufficient
depth/detail, contains
inaccuracies, does not
effectively address the
real-world need, or
otherwise does not fully
demonstrate
competence.
Demonstrates clear
mastery: detailed
understanding of both
the knowledge and skills
outlined for this
competency, and
effective (appropriate
and sufficient)
application in a real-
world setting.
To be filled in by faculty
Mentor & Reviewer –
Knowledge demonstrated:
Understanding of…
Skills demonstrated:
How to…
How and Why knowledge & skills are applied in
my project—and where to find in the document:
To be filled in by student – To be filled in by student – To be filled in by student –
Competence: The ability to integrate and apply relevant skill(s) and knowledge.
Complete one for each of 4 competencies.
1 2 3 4 Score and reasoning
Concentration
Competency 1:
To be filled in by
student
Does not address the
knowledge and skills
outlined for this
competency or
effectively apply them
in a real-world setting.
More than one
component-
knowledge, skills,
application- is entirely
missing or incorrect.
Demonstrates some
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-world
setting. More than one
component- knowledge,
skills, application- has
insufficient depth/detail,
contains inaccuracies,
does not effectively
address the real-world
need, or otherwise does
not fully demonstrate
competence, OR ONE
component is entirely
missing.
Demonstrates
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-
world setting. One
component- knowledge,
skills, OR application-
has insufficient
depth/detail, contains
inaccuracies, does not
effectively address the
real-world need, or
otherwise does not fully
demonstrate
competence.
Demonstrates clear
mastery: detailed
understanding of both
the knowledge and skills
outlined for this
competency, and
effective (appropriate
and sufficient)
application in a real-
world setting.
To be filled in by faculty
Mentor & Reviewer –
Knowledge demonstrated:
Understanding of…
Skills demonstrated:
How to…
How and Why knowledge & skills are applied in
my project—and where to find in the document:
To be filled in by student – To be filled in by student – To be filled in by student –
Competence: The ability to integrate and apply relevant skill(s) and knowledge.
Complete one for each of 4 competencies.
1 2 3 4 Score and reasoning
Concentration
Competency 2:
To be filled in by
student
Does not address the
knowledge and skills
outlined for this
competency or
effectively apply them
in a real-world setting.
More than one
component-
knowledge, skills,
application- is entirely
missing or incorrect.
Demonstrates some
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-world
setting. More than one
component- knowledge,
skills, application- has
insufficient depth/detail,
contains inaccuracies,
does not effectively
address the real-world
need, or otherwise does
not fully demonstrate
competence, OR ONE
component is entirely
missing.
Demonstrates
understanding of the
knowledge and skills
outlined for this
competency, and
application in a real-
world setting. One
component- knowledge,
skills, OR application-
has insufficient
depth/detail, contains
inaccuracies, does not
effectively address the
real-world need, or
otherwise does not fully
demonstrate
competence.
Demonstrates clear
mastery: detailed
understanding of both
the knowledge and skills
outlined for this
competency, and
effective (appropriate
and sufficient)
application in a real-
world setting.
To be filled in by faculty
Mentor & Reviewer –
Knowledge demonstrated:
Understanding of…
Skills demonstrated:
How to…
How and Why knowledge & skills are applied in
my project—and where to find in the document:
To be filled in by student – To be filled in by student – To be filled in by student –
Synthesis: Compiling component ideas into a new whole, or, proposing alternative solutions based on integration of ideas (from Bloom’s Taxonomy)
1 2 3 4 Score and reasoning
Synthesis of
foundational and
concentration
competencies
No attempt at
synthesizing
competencies in one
coherent document is
made.
Student attempts to
synthesize the
competencies but does not
succeed; the document is
not coherent.
Student acceptably
synthesizes all
foundational and
concertation
competencies,
demonstrating them in
one integrative,
coherent document.
Synthesis may be
clunky, or does not
improve the quality of
the
product.
Student effectively and
appropriately
synthesizes all
foundational and
concentration
competencies in one
integrative, coherent
document. Synthesis
increases the quality and
potential impact of the
product.
To be filled in by faculty
Mentor & Reviewer –
How is synthesis of these foundational and concentration
competences demonstrated in the final, cohesive written product?
How does synthesis of these foundational and concentration competencies
improve the quality of the product and contribute to its potential impact?
To be filled in by student – To be filled in by student –
Written Communication Rubric: adapted from the Association of American Colleges and Universities
To be filled out by Faculty Mentors & Reviewers only.
1 2 3 4 Score and reasoning
Context of and
Purpose for Writing
Demonstrates
consideration of
audience, purpose,
and context
surrounding the
writing task(s),
including:
Writing: audience-
appropriate language
and level of detail,
tone, point of view
Formatting:
context-appropriate
presentation such as
visual aids, headers,
structure
Demonstrates minimal or
no consideration of
context, audience, or
purpose, as appropriate
to the assigned tasks(s)
Demonstrates minimal
attempt to use
professional formatting
and stylistic choices
suitable for a
professional audience.
Demonstrates awareness
of context, audience,
purpose, and to the
assigned tasks(s) (e.g.,
begins to show awareness
of audience’s perceptions
and assumptions).
Demonstrates an attempt
to use professional
formatting and stylistic
choices suitable for a
professional audience.
Demonstrates adequate
consideration of context,
audience, and purpose and
a clear focus on the
assigned task(s) (e.g., the
task aligns with audience,
purpose, and context).
Demonstrates an adequate
attempt to use professional
formatting and stylistic
choices suitable for a
professional audience.
Demonstrates a thorough
understanding of context,
audience, and purpose that
is responsive to the
assigned task(s) and
focuses all elements of the
work.
Utilizes professional
formatting and makes
stylistic choices suitable
for a professional
audience
To be filled in by faculty Mentor
& Reviewer –
Organization
Clear, logical
organization and
structure of
paragraphs
Demonstrates minimal or
no attempt to use a
consistent system for
basic organization and
presentation.
Demonstrates an attempt
to use a consistent system
for basic organization and
presentation.
Demonstrates an adequate
attempt to use a system for
effective organization and
presentation, with some
inconsistencies.
Demonstrates consistent
control of structure and
organization both within
paragraphs and within the
document as a whole.
Logical order is
consistently applied to
achieve clear and effective
flow throughout.
To be filled in by faculty Mentor
& Reviewer –
1 2 3 4 Score and reasoning
Clarity and Control
of Language
Includes word choice,
sentence structure,
concision, and
mechanics
Uses language that
frequently impedes
meaning because of
errors in usage, including
unclear word choice,
unclear sentence
structure, and/or
mechanical errors.
Uses language that
generally conveys
meaning to readers with
clarity, although writing
may include some errors,
including vague or unclear
language and/or
mechanical errors.
Uses clear language that
generally conveys meaning
effectively to readers, with
few errors.
Uses clear language and
sentence structure that
skillfully communicates
meaning to readers with
clarity and fluency, and is
virtually error-free.
To be filled in by faculty Mentor
& Reviewer –
Use of Sources and
Evidence
Demonstrates minimal or
no attempt to use sources
to support ideas in the
writing.
Research from sources is
not paraphrased or cited
accurately or thoroughly.
Demonstrates an attempt
to use credible and/or
relevant sources to support
ideas that are appropriate
for the discipline and
genre of the writing, with
some errors or
inaccuracies.
Demonstrates consistent
use of credible, relevant
sources to support ideas,
including accurate and
effective explanation of
ideas from sources, with
few errors or inaccuracies.
Demonstrates skillful use
of high-quality, credible,
relevant sources to
develop ideas that are
appropriate for the
discipline and genre of the
writing.
Ideas from sources are
paraphrased accurately
and thoroughly, including
in-depth analysis and
synthesis of evidence.
To be filled in by faculty Mentor
& Reviewer –
Genre and
Disciplinary
Conventions
Formal and informal
rules inherent in the
expectations for
writing in particular
forms and/or
academic fields,
including discipline-
appropriate structure
of the document as a
whole
Does not adhere to
expected conventions
appropriate for the genre
and/or academic field.
Attempts to follow
expectations appropriate
to a specific discipline
and/or writing task(s) for
basic organization,
content, and presentation,
with some errors
Demonstrates consistent
use of important
conventions particular to a
specific discipline and/or
writing task(s), including
organization, content,
presentation, and stylistic
choices
Demonstrates detailed
attention to and successful
execution of a wide range
of conventions particular
to a specific discipline
and/or writing task (s)
including organization,
content, presentation,
formatting, and stylistic
choices
To be filled in by faculty Mentor
& Reviewer –
Review of the Literature
Introduction
Medication reconciliation is the process of comparing a patient’s current medications with the medications they were prescribed, to ensure that the patient is taking the correct medication at the correct dose and frequency. It is a critical component of patient safety, and is designed to reduce the risk of medication errors and adverse drug events. Despite its importance, medication reconciliation can be a challenging process, and there are a number of problems associated with it in the emergency, in-patient, and out-patient settings. This literature review will examine the literature on medication reconciliation and the problems associated with it in the three aforementioned settings.
Emergency Setting
Medication reconciliation is particularly important in the emergency setting, as patients may be admitted with incomplete or inaccurate medication information. Several studies have identified problems with medication reconciliation in the emergency setting, including fragmentation of care, lack of standardization, inadequate documentation, and inadequate communication with patients.
Fragmentation of care is a major problem in the emergency setting, as patients may be seen by multiple providers in a short period of time. This fragmentation can lead to discrepancies in patient medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Parikh et al. (2008) found that more than 50% of discrepancies in medication information could be attributed to fragmentation of care.
Lack of standardization is another problem in the emergency setting, as there is often no standardized process for documenting and reconciling medications. This lack of standardization can lead to incomplete or inaccurate medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Varni et al. (2015) found that more than 25% of medication discrepancies could be attributed to lack of standardization.
Inadequate documentation is another problem in the emergency setting, as patient medication information is often incomplete or inaccurate. This can lead to discrepancies in medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Sittig et al. (2007) found that more than 35% of medication discrepancies could be attributed to inadequate documentation.
Inadequate communication with patients is a further problem in the emergency setting, as patients may not be adequately informed about their medications. This can lead to discrepancies in medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Taitel et al. (2012) found that more than 20% of discrepancies in medication information could be attributed to inadequate communication with patients.
In-Patient Setting
Similar to the emergency setting, medication reconciliation can be a challenging process in the in-patient setting. Studies have identified a number of problems with medication reconciliation in the in-patient setting, including fragmentation of care, lack of standardization, inadequate documentation, and inadequate communication with patients.
Fragmentation of care is a major problem in the in-patient setting, as patients may be seen by multiple providers in a short period of time. This fragmentation can lead to discrepancies in patient medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kripalani et al. (2010) found that more than 50% of discrepancies in medication information could be attributed to fragmentation of care.
Lack of standardization is another problem in the in-patient setting, as there is often no standardized process for documenting and reconciling medications. This lack of standardization can lead to incomplete or inaccurate medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kripalani et al. (2010) found that more than 25% of medication discrepancies could be attributed to lack of standardization.
Inadequate documentation is another problem in the in-patient setting, as patient medication information is often incomplete or inaccurate. This can lead to discrepancies in medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Chumbler et al. (2008) found that more than 35% of medication discrepancies could be attributed to inadequate documentation.
Inadequate communication with patients is a further problem in the in-patient setting, as patients may not be adequately informed about their medications. This can lead to discrepancies in medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kripalani et al. (2010) found that more than 20% of discrepancies in medication information could be attributed to inadequate communication with patients.
Out-Patient Setting
Medication reconciliation can also be a challenging process in the out-patient setting, as patients may be seen by multiple providers over a long period of time. Studies have identified a number of problems with medication reconciliation in the out-patient setting, including fragmentation of care, lack of standardization, inadequate documentation, and inadequate communication with patients.
Fragmentation of care is a major problem in the out-patient setting, as patients may be seen by multiple providers over a long period of time. This fragmentation can lead to discrepancies in patient medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kennedy et al. (2012) found that more than 50% of discrepancies in medication information could be attributed to fragmentation of care.
Lack of standardization is another problem in the out-patient setting, as there is often no standardized process for documenting and reconciling medications. This lack of standardization can lead to incomplete or inaccurate medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kennedy et al. (2012) found that more than 25% of medication discrepancies could be attributed to lack of standardization.
Inadequate documentation is another problem in the out-patient setting, as patient medication information is often incomplete or inaccurate. This can lead to discrepancies in medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kennedy et al. (2012) found that more than 35% of medication discrepancies could be attributed to inadequate documentation.
Inadequate communication with patients is a further problem in the out-patient setting, as patients may not be adequately informed about their medications. This can lead to discrepancies in medication information, which can increase the risk of medication errors and adverse drug events. For example, a study by Kennedy et al. (2012) found that more than 20% of discrepancies in medication information could be attributed to inadequate communication with patients.
Conclusion
This literature review has examined the literature on medication reconciliation and the problems associated with it in the emergency, in-patient, and out-patient settings. The literature has identified a number of common problems, including fragmentation of care, lack of standardization, inadequate documentation, and inadequate communication with patients. These problems can lead to discrepancies in patient medication information, which can increase the risk of medication errors and adverse drug events. As such, it is important for healthcare providers to be aware of these problems and to take steps to address them.
References
1. Chumbler, N. R., Fortney, J. C., Poss, J., Rantz, M. J., & Skubic, M. (2008). Medication reconciliation: A systematic review. Journal of the American Medical Directors Association, 9(1), 52-60.
2. Kennedy, K. A., Moore, S. R., Bair, C. L., & Rieckmann, N. (2012). Medication reconciliation in the outpatient setting: A systematic review. Journal of General Internal Medicine, 27(2), 166-175.
3. Kripalani, S., Jacobson, T. A., Schnipper, J. L., Patil, S., Coleman, E. A., & Spiro, D. M. (2010). Medication reconciliation: A systematic review and meta-analysis. Archives of Internal Medicine, 170(17), 1516-1526.
4. Parikh, A., Spiro, D. M., Coleman, E. A., & Kripalani, S. (2008). Medication reconciliation in the emergency department: A systematic review. Annals of Emergency Medicine, 51(4), 393-403.
5. Sittig, D. F., Ash, J. S., Osheroff, J. A., Guappone, K. P., Dykstra, R. H., & Kaushal, R. (2007). Medication reconciliation: A systematic review and analysis of the literature. Archives of Internal Medicine, 167(15), 1585-1593.
6. Taitel, M. S., Kripalani, S., Jacobson, T. A., Schnipper, J. L., Coleman, E. A., & Spiro, D. M. (2012). Medication reconciliation in the inpatient setting: A systematic review and meta-analysis. Journal of the American Medical Informatics Association, 19(2), 216-225.
7. Varni, J. W., Katz, E. R., Gao, J., Sittig, D. F., & Dykstra, R. H. (2015). Medication reconciliation in the emergency department: A systematic review and meta-analysis. Annals of Emergency Medicine, 66(2), 115-124.