Retirement News : Seniors : Wheeler: Medication safety a cornerstone of elder care

Wheeler: Medication safety a cornerstone of elder care

Date Added: 25-03-2005

When you provide care to frail elderly and disabled residents, perhaps no task is as important as dispensing the right medication in the right dosage at the right time. This is what nursing facility caregivers are charged with doing each and every day. Great advances are being made in medication safety, but just as quickly, new challenges in this area arise.
 
     While medication safety is receiving major attention in varied health care settings, nursing facilities have a particularly demanding job: not only is the right medication/dosage/time critical, and often difficult given the number of different medications prescribed for most elders (seven medications per day, on average), but caregivers must be ready to monitor and treat a host of potential side effects and reactions that occur with frequency due to residents' advanced age and often-times debilitating medical conditions. A new population of residents who have recently left hospital care and have more intensive needs makes the task even harder.

The elderly and younger people with disabilities also more commonly develop adverse reactions to medications. It should be noted that these types of adverse drug events are far more common than medication errors occurring when incorrect dosages or drugs are administered.
 
     Moreover, the complicated drug regimens of many residents, featuring sophisticated new drugs that often do not interact well with other drugs, require caregivers to be focused, alert, and up-to-date.
 
     Another hurdle is the sheer number of drugs available today - many with similar names - which present many opportunities for confusion in any setting, hospital, nursing facility or the community.
 
     Because of these challenging conditions, nursing facility staff know that it is of the utmost importance that physicians, nurses, and pharmacists work in close coordination to ensure that residents have the right medication plan. As an added precaution against adverse drug events, clinical pharmacists in nursing facilities regularly review residents' medication regimens.
 
     Nursing homes also work closely with acute care facilities and home health agencies to improve patient safety as patients transition between sites of care. It is easy for a medication order to fall through the cracks as a patient is discharged from a hospital -- but we are working toward reducing the likelihood of this happening by working closely with our colleagues from the varied settings and improving the processes involved in patient transfers.
 
     Collaboration is not only occurring among providers, but among all of the players in health care today, including payors, regulators, and, of course, providers. The state has developed an inter-agency task force to develop protocols for medication safety and the nursing home provider community is an active participant in this group. The Massachusetts Coalition for the Prevention of Medical Errors is also focusing on drug safety by convening educational programs to benefit those across the health care spectrum.
 
     In addition to collaboration, technology must also play a major role in ensuring medication safety. The challenge here is mainly one of public policy - providing the financing through the major government payors of nursing home care -- Medicare and Medicaid -- to help nursing homes purchase cutting-edge tools such as the Computerized Physician Order Entry (or CPOE) systems that many hospitals use, which eliminate errors that result from handwritten prescriptions.
 
     Many community hospitals cannot afford these systems, let alone nursing homes. Yet we know this technology will save lives. We must develop solutions to bring this technology to nursing homes. Lives can be saved and there is no excuse for leaders from health care, government, and the technology sector not to work together to achieve a financing solution.
 
     Until there are no medication errors, we can always do better. And as a health care community and a society, we must vow to do better. But we also must take stock in the important steps that we have taken thus far and realize the dawn of a new day in medication safety is within our grasp.
 
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http://www.metrowestdailynews.com/columnists/view.bg?articleid=93941