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Who should do medication reconciliation safety: RNs, LPN or both?

December 19, 2015
by Pamela Tabar, Editor-in-Chief
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In most nursing homes, both registered nurses (RNs) and licensed practical nurses (LPNs) are permitted to perform medication reconciliations, but RNs are much more likely to discover discrepancies in medications than LPNs are, suggests new research from the University of Missouri.

The study included 32 RNs and 70 LPNs from 12 nursing homes across the state and found that RNs were more likely than LPNs to catch medication discrepancies, especially with high-risk medications.

“RNs and LPNs contribute to resident safety in different ways,” explains Amy Vogelsmeier, associate professor at the MU Sinclair School of Nursing and the lead researcher on the study, in a university release. “They both serve important roles; however, nursing home leaders must understand the distinct contributions of each role. For example, during a process such as medication reconciliation, which is executed differently by RNs and LPNs, understanding the differences will allow for the nurses’ different skill-sets to be more appropriately utilized.”

The study highlights the importance of training and in understanding the differences in how RNs and LPNs work, Vogelsmeier added.  “Nursing home work is hard. The ability to manage patients’ care and keep them stable is a clinical challenge that requires highly educated, clinically savvy nurses. Currently, RNs are not functioning in nursing homes to the full scope of their practice. RNs and LPNs are assigned the same responsibilities; yet, earlier research findings show that LPNs are more focused on tasks, whereas RNs are more focused on comprehensive assessment and resident safety.”

The study was published in the Journal of Nursing Regulation.




Federal law requires that all residents of skilled nursing facilities medications be reviewed at least monthly by a consultant pharmacist. Pharmacists are the medication therapy experts.