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medication errors



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Feb 20, 2005 07:50 PM

medication errors

by darla80
Updated Feb 20, 2005 at 07:52 PM by darla80

Interesting when I worked in the hospital nurses could get written up for med errors ..the pts go home and polypharmacy becomes russian roulette

*************************
My office is on a campaign to prevent medication errors

Patients are told to bring in ALLL medication bottles, to carrry an accurate list and I am tryng to help them identify what pills they take and why ..Of course this is time intensive.

what stategies does your office use?
and what are some of the most commen errors you see ?
here are few of my recent findings

true life..real time


I had a pt tell me she was taking her ABX as directed and when I looked at the bottle ..it was Darvocet

IM life

Pt states I am taking my "diabetes pill".... patient brings in meds and she thinks her lanoxin is a diabetes medication

IM life

pt brings in all pill bottles.. he is taking 20mg Accupril and 40mg of Lisinopril and wonders why he is dizzy ..BP 94/52
he does not know or understand these two medications are blood pressure meds . he was given by two seperate physcians and filled at two seperate pharmcies

IM life

pt taking actos 45mg and avandia 8mg .. BS are bottoming out and he does not know they are the same diabetes meds .



How can we help them?
I wonder if there could be a more collaborative effort on the part of the pharmacist, physician office, and the pt?

Looking forward to your ideas

Darla


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3 Comments
No. 1
Old Feb 20, 2005, 08:05 PM

Originally Posted by darla80
Interesting when I worked in the hospital nurses could get written up for med errors ..the pts go home and polypharmacy becomes russian roulette

*************************
My office is on a campaign to prevent medication errors
How can we help them?
I wonder if there could be a more collaborative effort on the part of the pharmacist, physician office, and the pt?

Looking forward to your ideas

Darla


The Rite Aid chain (any in your area?) keeps track of all my meds/interactions, etc. One line of defense is to not have more than one pharmacy.

Another line of defense, the patient has a med list with them at all times, which each doc can look at and sign and date with each visit.

Great project for yu guys to have!! :hatparty:
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No. 2
from darla80
Old Feb 20, 2005, 08:36 PM

we have two problems you just identified

many of our patients have two or more pharmacies.. do your pts do that?

they have their "mail in pharmacy" their local pharmacy, things they send ot the Canadian pharmacy and then we have some that use the Veterans hospital pharmacy..they see cardioliogy IM Uro etc .. not much continuity

We have worked on the med list angle .. I have cards made up for them to put in thier wallets..my doc prints out a list etc

then they go to another physician get a new med..do not put it on the list .. do not take the old meds off and they do NOT know why they take what they take ..

do I sound a little frustrated ?

Thanks for your input..I am still wearing my thinknig cap

Joy and Smiles * darla
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No. 3
from laurasc
Old Feb 21, 2005, 09:10 PM

Well, in my clinic we have a policy that a patient cannot get a med refill without seeing the doctor. They are to bring ALL their pill bottles to the doc's office and have it all filled at the same time. Does it always work? No. Most times it doesn't. Who's fault is it? I think it's a combination of doctor's and patient's fault. A patient comes in for a med review and two days later calls in because they forgot to renew one of them. Of course, it's then up to us nurses to phone in a refill.

We also have a pharmacist on staff as part of a clinical study. (to see if a pharmacist is effective in a family practice setting) We refer patients to her and she takes the time to go over medications with patients, teaching and sorting. She then makes recommendations to the doctors regarding their patients. She's been known to catch some real doozies.

One of our biggest problems is the drug seekers. One doc in particular has several of them. We're forever phoning pharmacies to check up on them. We've even caught them in lies. They must think we're stupid or something.

Personally I think that the "no refills till you see the doc" policy is a good one...assuming it's followed....which it's not all the time. A pharmacist on staff, even just part time, is an excellent idea...not only for the patients but also for the docs and nurses. I'm always running to her asking med questions. She's really amazing.

It's a real uphill battle...there's no doubt about that. It's really frightening when I ask a patient about a pill and I get "I don't know, it's the square green one."


Laura
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