Leaving Town Case Study

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

Our Town is a play that takes place near the turn of the century in the small rural town of Grover’s Corners, New Hampshire. The playwright, Thornton Wilder is trying to convey the importance of the little, often unnoticed things in life. Throughout the first two acts he builds a scenario, which allows the third act to show that we as humans often run through life oblivious to what is actually happening. Wilder attempts to show life as something that we take for granted. We do not realize the true value of living until we are dead and gone. The through-line of the action seems to be attention to the details of life. Wilder builds up a plot that pays attention to great details of living.

patients follow directions and be aware of potential interactions with other drugs. Don’t just change your dose without discussing with your doctor first. Never use another persons prescription.

Use at least two patient identifiers when providing care. Double checking of ID bands and ID/Driver’s license of patient if possible. Using labels to mark all materials /items needed for the procedures. A two person check off procedure must be implemented. Items requiring labeling include: patient records, signed consents, and all assessments, diagnostic tests and x-rays. Also included should be any item that is needed for the procedure (blood products, devices, and equipment). Using a matching system, so that all items in the procedure area are matched to the patient. The matching system must be completed by a minimum of two staff members. These staff members should include a qualified staff member, nursing staff involved in the procedure, recovery room staff, and discharge staff.

Medication Reconciliation is defined by the Joint Commission as the process of checking and rechecking a patient’s current medication list to the patient’s orders. Within a MedRec program, three steps must be followed to ensure patients have the correct medications at admission and discharge: Verification, Clarification, and Reconciliation (Greenwald et al., 2010; Ruggiero et al,. 2015). MedRec should not occur once, but multiple times especially when a patient moves from department to department. The more a patient moves, the more liable they are for a medication error due to poor communication. MedRec is done for the simple reason of catching those medication errors and correcting them before they can do any harm (The Joint Commission, 2006). Medication errors effect nearly 1.5 million people who enter the hospital setting in the USA. At least every patient has one medication discrepancy between admission and discharge, which leads to rehospitalizations due to hospital-setting medication errors (Institute of Medicine as cited by Wilson et al,. 2015). With nurses at the forefront of a patient’s medication regime, pressure is put on them to provide the necessary education and safety to prevent medication related rehospitalizations. Included in the causes for medication errors is miscommunication between departments taking care of the same patient (Allison et al., 2015). Many medication errors are preventable by the implementation of electronic orders. The use of electronic

The Information Technology Manager is to develop a Standard Operating Procedure for all Care Units to require the use of computerized demographic labels printed on-demand from Hospital LIS at the time of initiating patient orders. The labels’ quantity must be sufficient for each patient’s order to be placed on appropriate forms, as well as on all sample containers and tubes at the time of collection. Internal Audits are to be conducted on a quarterly basis in order to determine the effectiveness of this change.

The Information Technology Manager is to develop a Standard Operating Procedure for all Care Units to require the use of computerized demographic labels printed on-demand from Hospital LIS at the time of initiating patient orders. The labels’ quantity must be sufficient for each patient’s order to be placed on appropriate forms, as well as on all sample containers and tubes at the time of collection. Internal Audits are to be conducted on a quarterly basis in order to determine the effectiveness of this change.

The medication reconciliation process compares the medications taken by a patient prior to admission to a facility with medication orders at the facility. The Joint Commission (TJC), the accrediting body for health care organizations, stipulates that the medication reconciliation process must be completed within 24 hours of admission (Sentinel Event Alert, Issue 35, 2006). This process begins with compiling an accurate list of the patient's home medications which are also referred to as prior to admission (PTA) medications. At Poudre Valley Hospital, it is the job of the Pharmacy Admission Specialist (PAS) to compile and verify this list. The PAS must collect, record and communicate to the provider an accurate list of the patient's

The patient also tells me she uses lorazepam very intermittently. She is almost out of that medication would like a refill today. I did write her for lorazepam 0.5 mg to use p.r.n. #20 with no refills.

There are four important steps at Walgreens to ensure the prescriptions are dispensed accurately and safely. The four steps has its own buttons on the computer screen system and allows for the pharmacists and the technicians to see at what step the patients’ medications are. The first step is the Rx entry. All prescriptions in the Rx entry can be found by pressing the F1 key. This step is where all the prescriptions and E-scripts go in. All the patients’ information, insurance, and prescription information is entered into the system. All the refills, new scripts, and even insurances rejections are handled at this step. Once the prescriptions went through, any hardcopy prescriptions will be scanned onto the computer and will move on to the next step.

Step2: Main pharmacy pharmacist or clinical pharmacist in the responsible floor verify the order; if it is correct, then go to step3; if the pharmacist has some questions or concerns about the order, contact the physician or nurse practitioner to address. Pharmacists check the indication, effectiveness, safety, and convenience of the medication. Time spent: 5 minutes

In 2003, The Joint Commission made one of their first goals to improve the accuracy of identifying patients to reduce or eliminate patient identification errors. This continues to be an accreditation requirement. Their recommendations to do this are to use at least two patient identifiers when administering medications, and when providing treatments or procedures. Acceptable identifiers may be the individual’s name, an assigned identification number, telephone number, or other person-specific identifier. Patient room number or physical location may not be used as an appropriate identifier. Healthcare provides should re-identify the patient with each encounter, each medication pass, and each procedure. There have been procedures and protocols throughout the country have been put into place to make the care provided to patients safer. Another element of this requirement is that all containers should be labeled in the patients presences after using the patient identifiers

Once they return them to you, please make sure to give a copy to school nurse. Student must be carrying unexpired medication daily while on campus.

Patient demographics (full name, date of birth, emergency contact information, next of kin, employer information etc...)

In order to void miscommunication between the doctor and patients, procedures should be setup to help the doctors collect basic information about the patients. This procedure includes getting patients fill out forms