Improving Medication Accuracy
Medication errors are a common safety risk for patients, particularly those who are hospitalized. According to the Institute of Medicine’s 2006 Preventing Medication Errors report, the average hospitalized patient is subject to at least one medication error per day, of which 20 percent are believed to be harmful.
These errors are more frequent in relation to care transitions, for example, changes from one area of a care facility to another, shift changes of caregivers, and discharges to home or elsewhere.
According to the NCBI publication Patient Safety and Quality: An Evidence-Based Handbook for Nurses, one of the keys to avoiding these errors is a well-documented and closely followed process of medication reconciliation. This process includes:
- Developing a list of current medications for each patient,
- Developing a list of medications to be prescribed,
- Comparing the two lists,
- Making clinical decisions based on the comparison of the lists, and
- Communicating the new list to appropriate caregivers and to the patient.
Medication reconciliation sounds like a more straightforward process than it actually is because there are few standards for gathering the information, organizing it and communicating it to caregivers. Gaps in information can be a problem in cases where a patient is unable to accurately list their current medications and nutritional supplements. Finally, the process is time-consuming, which means that it can go by the wayside in emergency situations and other circumstances where different priorities take precedence.
The Institute for Healthcare Improvement recommends that health care professionals use a standardized form to ensure that medication reconciliation takes place and is accurately carried forward throughout a patient’s care experience. Frequent reviews of the information are recommended, particularly when a patient’s list includes high-risk medications.
Last but not least, medical professionals should enlist the help of the patient and his or her family members or other caregivers to make sure the patient’s list of medications is properly maintained and updated. Have patients bring their medications to each medical visit and educate them about the medications so it is clear that they understand:
- What each medication is for (what it is intended to do for them),
- Why it is prescribed as it is (for example, to be taken at a particular time of day, with or without food, etc.),
- How long it must be taken (for a certain range of time or indefinitely),
- Possible negative interactions with food, other drugs or nutritional supplements, and
- Common side-effects they may experience, including what to do if they have one or more of them.
These initiatives should help patients keep closer track of their own medications and improve their dosage compliance and overall safety.