Tuesday, April 5, 2011

Protect yourself: how to prevent medication errors

MAR 17Image by Justin Brockie via Flickr
I'm sure that nearly everyone has heard the horror stories about what can and has happened  in the hospital when medication errors occur: allegations of neglect fly, the threat of lawsuits loom over the heads of the medical staff involved and the patient is at risk for life threatening injury and negative outcomes.

What can you do to minimize and eliminate an error such as this?  Let's consider some information.

The facts

According to the Institute of Medicine, up to 100,000 people are estimated to die in U.S. Hospitals each year as a result of medical mistakes-more than those who die from motor-vehicle accidents, breast cancer or AIDS.

Medication errors can occur because of  misunderstanding in the written physician order. This results in inaccurate information being written in the patient MAR (medication administration record). Other errors may occur when the order is incorrectly transcribed by unit clerks or nurses. There are a system of checks in place however, but sometimes mistakes just aren't caught.  For example, before a new medication is administered, two nurses must review the info in the MAR with the physician's order in the chart for accuracy.  This does eliminate many errors, but a few get missed.

Errors also can be made in the pharmacy resulting in the wrong med being sent to the floor.   In the pharmacy meticulously accurate records must be maintained on all patients. During peak times paperwork errors occur. Sometimes pharmacists and techs may mistakenly send the wrong medication to the unit.

Fatigued nurses may  administer the wrong medication to the wrong patient. This underscores the fact that communication between the doctor and patient is of utmost importance. Patients should always ask the doctor if he is making changes to his medication regimen. This may help eliminate the instance of errors in some cases. What else can you do?

Below are 10 suggestions that may help save your life.

What you can do to eliminate errors

These suggestions are combinations of steps that you can take whether you are inpatient or outpatient.

1. Be proactive in your care.  Don't leave everything to the doctor's judgment. Talk to him and ask questions.

I can't tell you the number of times that patients have asked me questions or expressed concerns after the doctor has left the unit.  When I then inquire if they've spoken to the physician, the answer is almost always, "no."

2. Make sure that you tell your doctor about medication allergies.  This is vital! Please make an accurate list of your allergies. This is your responsibility. If there is an elderly parent involved, please write the information for her.

Returning patients often come into the hospital ED and say things like, "Oh, the hospital has a list of my allergies."   Who has time, in the event of a true medical emergency, to look up records?  Besides, new allergies can form that haven't been entered into the old chart.

3. Make sure that you tell your doctor about all medications that you take. This could prevent the duplication of medications.

4. Double check all prescriptions. Does the medication on the prescription match what the doctor just told you?

5. Let the doctor know if you don't recognize the shape, color or size of a medication if you are inpatient in the hospital. Notify the pharmacy if you are at home and tell them that the medication is different in appearance.

6. Ask, ask and ask questions.

7. Take a loved one to the doctor with you. Maybe they can pick up something that you missed.

8.  Check the side effects of medications.

8. Have the doctor explain all procedures in plain language.

9. Ask about infection control policies.

10. Insist on proper hand hygiene.

The last two suggestions have to do with infection control practices to help cut down on the over use of antibiotics, which can results in antibiotic resistant organisms like MRSA.

Sources: "House Call"  10 tips to prevent medical errors Essence Magazine.

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