The elderly are at the highest risk of death due to medication errors. Here’s how to reduce the risk of mistakes when caring for the aged.
Medication errors are a scary reality and effect approximately 1.3 million people each year in the United States. According to the National Coordination Council for Medication Error Reporting and Prevention, a medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, caregiver or consumerâ€¦related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing’ distribution’ administration; education; monitoring; and use.
Medication errors in the elderly occur due to various reasons. A 2007 Institute of Medicine report states that each week four out of five adults in the United States are taking over the counter drugs, prescription medications and/or dietary supplements. The sheer magnitude of use increases the risk of an error occurring. Â Handwriting that is ineligible, drug names that look like other drug names, the constant flow of new drugs into the market, and similar packaging are among some causes. Currently there are over 33,000 trademarked brand names and 9,000 generic drug names in the United States. This large quantity of different medication available, further complicates and increases the risk of medication errors.
Hospitals tend to have the most problems with medication errors. This is most likely due to the sheer volume of patients, the unfamiliar medications prescribed and the health of the patient who is relying on others to catch any errors. There are risk reduction strategies that can be, and are being, done at hospitals to cut down on medication errors. A Massachusetts General Hospital study found that when a pharmacist was added to doctors doing rounds in intensive care units, prescription errors were cut by 66%. Another strategy is to use IV drugs mixed by the manufacturer, premixes. A study showed that there is a 20% error rate when IV drugs are mixed by nurses, 9% when mixed by pharmacists, but only 0.3% when mixed by the manufacturer. Also, the practice of unit dosing has been shown to decrease errors by limiting the need to calculate, measure or prepare the drug.
Another way to reduce medication errors is to utilize technology. Ideally computerized order entry tends to be the most reliable because of the elimination of handwriting errors. Â All health care organizations should utilize pharmaceutical software. Thorough computer software will highlight patient allergies, duplicate prescriptions, drug-drug interactions, route of administration and inappropriate doses for the health care provider.
What else can be done to decrease medication errors in elderly patients?
- Avoid using cursive or abbreviations
- Indicate what disease process the drug is to be used for on the prescription
- Avoid trailing zeros, symbols and using a period after abbreviations
- Communicate to the patient the name of the drug and also what it is used for
- Of course, verify any unclear prescriptions with the doctor
- Keep medications that sound alike physically separated
- Review with the patient the name of the drug and what it is used for
- Pull from floor stock any potentially lethal concentrated solutions or high risk medications
Patients and Caregivers
- Keep all of your doctors informed of any medical changes
- Communicate all prescription, over the counter medications, and vitamins or minerals with your health care provider
- Know the name and dosage of drugs to be prescribed
- Have your doctor write out what medication and dose you should be taking and the dose and bring this with you to the pharmacy to check against the prescription
- Have your doctor write what condition the medication is treating in directions for use
- Use a pill organizer
- Have your pharmacist review the medication with you
- At a hospital, bring a current home medication list and always have your drugs reviewed before taking them