Introduction/Background There is now is an increasing population of elderly patients who is not receiving the proper guidance when it comes to their disease states and medications. More specifically, elderly patients in independent nursing homes are responsible for filling, picking up and taking their own medications from pharmacies outside the nursing home without any help. This means they have to remember to put in the refills, remember to pick up the medications and then remember to actually take the medications at the right times. Studies have shown the lack of guidance in the independent homes often results in many errors that may even lead to fatalities. One study showed that “the most common types of errors resulting in patient death involved administering an improper dose (40.9%), administering the wrong drug (16%) and using the wrong route of administration (9.5%)”1. Pharmacists play a crucial role in preventing these common types of errors. Through proper counseling sessions, the pharmacist has the ability to convey the correct information to the patient about their medication regimen. Aside from the significant need of fixing medication errors, there is a large need for patient education on their disease states and disease state management. Educated patients will want to be more cautious of their therapy, reach full therapeutic efficacy and slow the progression of their disease states. One study showed that after conducting a meta-analysis on 360 studies, 64%
Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.
As it is mentioned earlier, medication administration includes various steps and an interdisciplinary team. Undoubtedly, nurses play a vital role in the medication administration process. Since patient safety is the priority to all health care professionals, it is important for the nurses to effectively communicate and collaborate with an interdisciplinary team if he or she is unsure about any medication prescription to prevent any adverse events. In addition, patient education is another component of safe administration. A patient must be educated on medications they are taking, the reason for taking them, the dosage, a route, potential side effects, and interactions. Nurses should perform “six rights” of the medication each time. Before administering
The purpose of this paper is to bring forth awareness when it comes to patients and medication errors and further educates health care professionals on the importance of communication especially during transition of care. According to Williams and Ashrcoft (2013) “ An estimated median of 19.1 % of total opportunities for error in hospitals.” Although not all medication errors occur during transition it is the time most prevalent for these errors to occur. As per Johnson, Guirguis, and Grace (2015) “An estimated 60% of all medication errors occur during transition of care. The National Transitions of Care Coalition defines a transition of care as the movement of patients between healthcare locations, providers, or different levels of care within the same location as their conditions and care needs change, [and] frequently involves multiple persons, including the patient, the family member or other caregiver(s), nurse(s), social worker(s), case manager(s), pharmacist(s), physician(s), and other providers.”
One of the critical core components of Skilled Nursing Facility is medication administration. As cited by Tenhunen, Tanner, and Dahlen (2014), they stated that 88% of the residents living in the nursing homes are aged 65 years old and older. They discussed that every five of administered medications in nursing home has one probability of error. This means that about half of the residents have the possibility of two or more medication errors daily. This applies to the Pasadena Care Center (PCC) because its residents are mostly older adults who require medications on a daily basis. Moreover, residents are prescribed with multiple medications, which make them vulnerable to medication errors. The staff at PCC is trying their best to ensure safe medication administration, however, it still in need of a major change. The goal of the proposed change is to decrease the medication errors in this organization to ensure patient safety.
As clinical site co-ordinator with many years of clinical experience I feel competent in the drug administration via a variety of routes. Generally the patients I attend have become acutely unwell with most prescriptions not having the third eye of a pharmacist and most drugs being delivered intravenously. It is imperative therefore that the prescription and drugs always be thoroughly checked which relies on good communication throughout. Furthermore, most emergency drugs have a protocol for administration developed by the hospital. However within this situation the nurse is generally the last defence before any medication error actually occurs, therefore it is the nurses responsibility to ensure the prescription is correct and to challenge prescription written
Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital
In the Institute of Medicine (IOM) report in 2006, Preventing Medication Error, more than 1/3 of the 1.5 million adverse drug events that were recorded in the United States each year occurred in an outpatient setting. Likewise, in 2008 IOM released a report that laid emphases on the need for setting universal standards within prescribing and dispensing practices. Multiple studies reported that an increased prevalence of patient adherence to taking prescribed medications can be compromised by their inability to comprehend or understand the directions for taking the medication (Wolf et al., 2016). The inability to understand and interpret prescription drug labels were recognized as the leading cause of a large proportion of outpatient medication error and adverse events, as patients may possibly accidentally misuse a prescribed
Nearly half of seniors do not take their medications when or how they were prescribed. There are mistakes on dosages, methods of delivery, time of delivery, what they should be taken with, and even if they should still be taken. Compounding the issue, most seniors over the age of 65 are taking between 8 and 13 different medications. Put these numbers together and it is no wonder that problems with medication management are one of the leading reasons seniors end up in the emergency room, and is the number one reason seniors end up back in the hospital after being recently discharged. According to a study published in "Pharmacotherapy", nearly 70 percent of hospitalized seniors suffered from at least one
The US is an aging society like many societies around the world and as a result, there is an increase in the number of patients admitted to nursing homes. The elderly population is a fragile population that undergoes mental and physical decline in health. This increases the number of medications used, which increase the risk of adverse drug reactions due to drug-drug and drug-disease interactions. Pharmacists have become increasingly active in nursing homes by providing medication therapy management services, but the benefit in reducing prevalence of these adverse drug reactions is not fully understood. Medication therapy management is a growing field that has been incorporated by pharmacists in different states to optimize therapeutic outcomes in individual patients. Understanding the relationship between medication management and drug- drug
In the United States today, the elderly make up approximately 13% of the population but use 30% of all prescriptions written. This article focuses on the importance of understanding patients’ prescriptions and their adverse drug events (ADE), as well as the best ways to care for patients with many prescriptions. The article also discusses the best ways to avoid ADEs.
According to Kennedy (2010), “Medication errors continue to cause significant morbidity and mortality. Thus, in turn, cost the health care system millions of dollars each year in preventable costs.”(p.1). For this reason, a service such as Medication Therapy Management, also known as (MTM), which can be described as a diverse service or services that focus on drug therapy with the objective to improve healthcare services was introduced throughout the health care systems. This is done by improving pharmaceutical safety which results in enhanced therapeutic results for individual patients, meanwhile reducing cost for both the patients and healthcare institutions. In order for MTM to be successful and to ensure that patients get more
“According to the Institute of Medicine’s Preventing Medication Errors report, the average hospitalized patient is subject to at least one medication error per day” (Barnsteiner, 2008, p. 2-459). A patient’s home medication regimen is frequently continued during hospitalization. It is often found that during the process of interviewing a patient to collect all relevant data associated with their medication history, over 60% of inpatients had at least one error on their prior to admission medication list (Salanitro et al., 2012). The many challenges and current inability to accurately identify medications taken at home can lead to potential adverse events. “An adverse drug event (ADE) is defined as harm experienced by a patient as a result
Medication error is one of the biggest problems in the healthcare field. Patients are dying due to wrong drug or dosage. Medication error is any preventable incident that leads to inappropriate medication use or harms the patient while the medication is in the control of the health care professional,or patient (U.S. Food and Drug Administration, 2015). It is estimated about 44,000 inpatients die each year in the United States due to medication errors which were indeed preventable (Mahmood, Chaudhury, Gaumont & Rust, 2012). There are many factors that contribute to medication error. However, the most common that factors are human factors, right patient information, miscommunication of abbreviations, wrong dosage. Healthcare providers do not intend to make medication errors, but they happen anyways. Therefore, nursing should play a tremendous role to reduce medication error
Caregivers should be informed of elders’ medication. Elders are likely to make several mistakes in their prescribed medication that can jeopardize their health, and most of the mistakes emanate from their age and health conditions. Most of the time, the elders see many caregivers because they suffer from various disabilities that need different specialists (Wisocki 64). Lack of communication between the caregivers or between the elder and a caregiver to inform him or her about previous prescriptions may lead to a prescription that causes health complications. Inappropriate practices can emanate from overmedication, inaccurate evaluation and diagnosis, inappropriate medication for a diagnosis, and failing to assess drug interactions (Wisocki
A combination of these two things force Gogol to attempt to disregard his culture, change his name, and ultimately have a new identity.