Kristia Marie Fetalino
Title:
- Determinance of common medication errors among secondary hospital in First district of laguna.
Statement of the Problem:
- What kinds of medication errors are most common?
- What are the common factors of medication errors?
- How often does medication error happens?
- What is the percentage of patient safety in medication errors?
- What are the necessary steps in preventing medication errors?
- Why pharmacist should care about avoiding medication errors?
Title (Back-up)
- Common factors that leads to stock out of drugs at the hospital pharmacy department towards improving sufficient medication use of patients.
- Factors of stock out
Related:
Title: Why employers should care about avoiding drug errors
Author(s): Roger W. Anderson
Source: Business Insurance. 40.47 (Nov. 20, 2006): p10. From Expanded Academic ASAP.
Document Type: Article
Full Text: COPYRIGHT 2006 Crain Communications, Inc.
http://www.crain.com/about/index.html
Full Text:
Byline: Dr. Roger W. Anderson
While medication safety is more likely to be a priority within the health care community than in the board room, it should also be a major concern for employers.
The Institute of Medicine's report issued in July, which estimates that preventable medication errors injure at least 1.5 million Americans annually, brings into sharp focus the seriousness of this problem. The costs are not obvious, but they directly harm employers' bottom lines through additional hospitalization costs, increased disability payments and a drain on productivity in the workplace.
The report portrays a grim picture of the state of prescription medication use in the United States. However, there is room for optimism. Some managed care organizations and pharmacy benefit managers have been using many of the tactics outlined in the report to reduce prescription drug errors. These solutions need broader adoption to fully address the problem.
The solution is a matter of simple communication between all the parties taking part in providing care. Some of the recommendations are as basic as patients sharing lists of the medications, vitamins and supplements they use with their health care providers. Other solutions are technologically driven to ensure accurate communication between doctors and pharmacists, including having all prescriptions transmitted electronically by 2010 to avoid handwriting and transcribing errors. The Centers for Medicare and Medicaid Services estimates that use of e-prescribing could eliminate as many as 2 million harmful drug events nationally each year.
Information technology will play a huge role in making the leap to improving medication safety. Electronic patient records and integrated data networks that connect medical, pharmacy and diagnostic lab data are a major step toward preventing medical errors overall, as well as prescription drug errors.
However, these records need to be designed to alert doctors and pharmacists about potential conflicts in care. These conflicts come from drug-to-drug interactions, drug/disease interactions, errors of omission (failing to provide an essential treatment) or duplicative treatments, for example. Also, many e-prescribing programs have features that conduct drug reviews that check a patient's history and current medications and will alert pharmacists if there is a problem. For example, an electronic prescribing initiative in the Detroit area has resulted in 98,000 prescription changes due to drug interaction alerts since the program started in February 2005.
These solutions are in place, but slashing 1.5 million medication errors per year will require broader implementation of them.
The Institute of Medicine's report encourages health care suppliers to become "high reliability organizations preoccupied with improving medication safety.'' Businesses should ask their health care providers questions about programs to improve medication safety when shopping for health plans or determining what providers should be in their network.
While that might seem off the track from the core issues of price and coverage, medication errors skew overall costs. The report noted that each adverse drug event in a hospital added about $8,750 to the cost of a hospital stay, leading to about $3.5 billion in avoidable costs nationwide-a figure that the institute admits is extremely conservative, with real costs likely much higher.
This does not even account for additional costs to the employee and employer. Employers have to contend with hiring temporary help or making do with a smaller staff while an employee convalesces, as well as medical, disability and potential rehabilitation costs.
Addressing the problem of medication errors is one tactic toward chipping away at preventable health care costs. According to the Kaiser Family Foundation, health care coverage costs for a family of four is approaching $11,000 annually.
There needs to be an equal commitment on the part of business to improve health care quality on behalf of employees. A heightened awareness of medical errors will force employers to become more selective about their health care providers.
It will also drive employers and health plans to educate employees about this and also make them more demanding about the care they receive. This issue is too important for passivity.
Each day spent in the hospital exposes the patient to one medication error per day. Those odds are too serious for patients and employers to remain passive and the costs of poor quality in this realm are too significant.
Dr. Roger W. Anderson is senior vp, chief pharmacist at Medco Health Solutions Inc., based in Dallas.
Dr. Roger W. Anderson
Source Citation (MLA 7th Edition)
Anderson, Roger W. "Why employers should care about avoiding drug errors." Business Insurance 20 Nov. 2006: 10. Expanded Academic ASAP. Web. 26 July 2013.
Document URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA154769159&v=2.1&u=phuphs&it=r&p=GPS&sw=w
Gale Document Number: GALE|A154769159
Title: Medication safety issue brief: small and rural hospitals--unique challenges, unique solutions
Source: H&HN Hospitals & Health Networks. 79.11 (Nov. 2005): p45. From Expanded Academic ASAP.
Document Type: Article
Full Text: COPYRIGHT 2005 Health Forum, Inc.
Full Text:
6 of 6 in a series
Series III
Improving patient safety and reducing medication errors at small and rural hospitals is part six in a six-part series that highlights underlying causes of and solutions to medication errors. This series is a joint effort of the American Hospital Association, the American Society of Health-System Pharmacists and Hospitals & Health Networks, with generous support from McKesson. You may tear this card out for future reference. Additional copies are available in PDF format, along with those from two previous series, on the ASHP and H&HN Web sites (www.ashp.org and www.hhnmag.com).
* SUMMARY
Small and rural hospital pharmacies face the same quality challenges as their large, urban counterparts. Yet, they often lack access to the necessary resources to address these issues. That's no minor problem. AHA Hospital Statistics 2006 reports that 2,003 (41 percent) of the nation's 4,919 community hospitals in 2004 were rural. And, as of Aug. 31, 2005, 1,141 hospitals in the United States are designated as critical access hospitals. People living in rural areas are less likely to have insurance and are by and large poorer than those who live in urban areas, according to the National Rural Health Association. The rural population is also older and tends to suffer from more chronic diseases than residents of urban areas. That adds to the challenge for small and rural hospitals. These facilities must treat complex medical cases with limited resources, often with minimal on-site pharmacy coverage.
* ISSUE BRIEF
Attracting pharmacists to practice in rural areas has long been a problem. A study last year of patient safety initiatives at critical access hospitals found that the mean number of on-site hours by a pharmacist was 23.8 hours per week. One-third of the 474 CAHs who participated in the survey by the Flex Monitoring Team, a consortium of the Rural Health Research Centers at the Universities of Minnesota, North Carolina and Southern Maine, reported that they had a pharmacist on-site only between one and 10 hours per week.
"The ability to review pharmacy orders in a timely manner at small and rural hospitals is a struggle," says Michelle Mandrack, a medication safety specialist with the Institute for Safe Medication Practices. As a result, more of these hospitals are outsourcing pharmacy operations during off hours or are partnering with other hospitals to share resources. The joint Commission on Accreditation of Healthcare Organizations earlier this year considered a change to its medication management standards requiring that when an on-site pharmacy is not open 24 hours a day, seven days a week, the organization must make arrangements for a pharmacist to review orders during off hours. Although the proposal is on hold, organizations including the American Society of Health-System Pharmacists continue to support the change as a means to improve medication safety and overall quality of care.
Limited financial resources are also a big barrier for small and rural hospitals. Many lack the capital to implement information technologies and equipment that are proven to reduce medication errors. "It's difficult to convince administration that a pharmacy information system is needed when it can account for half of an organization's $50,000 IT budget," says Teresa Rubio, ASHP's director of the sections of Inpatient Care Practitioners and Pharmacy Practice. But, adds Matt Fricker, a program director at ISMP," You don't have to spend a lot of money to improve medication safety."
* CASE STUDIES
Paynesville (Minn.) Area Health Care System: A 25-bed CAH, Paynesville provides pharmacy services from 7 a.m. to 5 p.m. during the week and for three to four hours a day on the weekends. During off hours, the hospital's 2.5 full-time equivalent pharmacists are on-call to review orders. "Due to cost, we cannot contract for after-hours service at the present time," says Todd Lemke, director of pharmacy. The hospital is looking into arrangements with other small and rural organizations to help defray the costs of providing full-pharmacy coverage. In the meantime, the hospital is working to address other medication safety issues. "We had a problem with error reporting," says Lemke. "Previously, we relied on a paper-based reporting system that was time-consuming and required the individual's identity." As a result, the hospital received less than a handful of error reports each month. The hospital developed a Web-based, anonymous reporting system; about 600 errors were reported in its first, full year in operation.
Watauga Medical Center, Boone, N.C.: A 117-bed acute care hospital in western North Carolina, Watauga Medical Center has had a difficult time finding pharmacists to fill shifts to provide around-the-clock pharmacy coverage. The hospital pharmacy is currently open from 7 a.m. to 11 p.m. Monday to Friday and 7 a.m. to 7 p.m. Saturday and Sunday. The nursing staff wanted 24-hour coverage. Stephen Novak, director of pharmacy services, approached a larger hospital about providing overnight coverage, but the hospital declined. He has since outsourced pharmacy coverage during off hours and high-volume times. "The nursing staff is pleased," he says. "We are experiencing a nursing shortage and a pharmacist shortage and this relieved pressure on both sides."
Regional West Medical Center, Scottsbluff, Neb.: A 185-bed referral center in western Nebraska, Regional West has turned to technology to improve operations. "We have a really large pharmacy inventory," says Brenda Hall, vice president of patient care services. "We do just about anything for anybody." The medical center integrated an electronic medication administration record with its clinical and nurse documentation system. Bar coding is in place throughout the hospital, with the exception of the emergency room. And, a pilot program for computerized physician order entry is under way. "We've had about a 30 percent reduction in medication errors since we implemented bar coding three years ago," Hall says. The hospital plans to automate the dispensing process by 2007. Convincing administration that these IT investments should be a priority was not difficult. "It's not that people don't believe in the value of the technology, it's that we have so many competing needs," she says.
ACTION Agenda
Here are some tips to improve medication safety:
1. Review storage of medications, particularly for those deemed high alert. Store these medications in separate locations.
2. Use standard concentrations and premixed solutions whenever possible to eliminate variation in practice.
3. Consider options to expand coverage so a pharmacist can review medication orders before administration to the patient 24 hours a day, seven days a week.
4. Encourage error reporting.
ADDITIONAL RESOURCES:
* American Society of Health System-Pharmacists Small and Rural Hospital Resource Center, www.ashp.org/srh
* The Institute for Safe Medication Practices, www.ismp.org
* The Department of Health and Human Services' Health Resources and Services Administration Small Rural Hospital Improvement Grant Programs, http://ruralhealth .hrsa.gov/ship.htm
* IOM Report: Quality Through Collaboration: The Future of Rural Health Care, www.nap .edu/books/0309094399/ html/
Source Citation (MLA 7th Edition)
"Medication safety issue brief: small and rural hospitals--unique challenges, unique solutions." H&HN Hospitals & Health Networks Nov. 2005: 45+. Expanded Academic ASAP. Web. 26 July 2013.
Document URL
http://go.galegroup.com/ps/i.do?id=GALE%7CA147214320&v=2.1&u=phuphs&it=r&p=GPS&sw=w
Gale Document Number: GALE|A147214320