You Are Working At A Long-Term Care Facility And Have 008606

You Are Working At A Long Term Care Facility And Have Been Appointed T

You are working at a long-term care facility and have been appointed to serve on a new committee. The purpose of the committee is to improve medication safety in the facility. Currently, the medication orders are handwritten in each patient’s chart. The orders are then sent to the pharmacy via fax. The nurses copy the medication orders by hand onto the medication administration record (MAR). The facility does not use barcoding or computer-generated MARs. Medications are supplied from the pharmacy in bulk rather than in unit dose.

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Medication safety is a critical concern in long-term care facilities, where residents often have complex medical needs and are at heightened risk for medication errors. The current system at this facility, characterized by handwritten medication orders, fax communication with the pharmacy, manual transcription onto MARs, and bulk medication supply, presents several potential points of failure that could lead to medication errors.

One significant source of risk stems from handwritten orders. Handwriting illegibility can cause misinterpretation of medication names, dosages, or instructions. This issue is exacerbated by the reliance on manual transcription by nurses, which can introduce human errors such as omissions, misreading, or incorrect documentation of orders onto the MARs. Additionally, transmitting orders via fax increases vulnerability since faxed documents can be incomplete, misdirected, or misread if the quality of the fax is poor.

The lack of barcoding and electronic systems further compounds these risks. Without barcoding, verification of medication administration relies solely on manual checks, which are prone to human error. The use of bulk medications instead of unit doses complicates inventory control and increases the likelihood of administering the wrong medication or dose, especially when identifying medications visually under time constraints or poor lighting conditions.

Another process issue is the potential delay between prescribing and administering medications. Handwritten orders require manual follow-up and transcribing, which can cause delays, especially if the staff is overburdened. The absence of a computerized system means that real-time updates and alerts for allergies, contraindications, or duplicate therapies are not available, increasing the risk of adverse drug interactions or allergic reactions.

Developing solutions to these process issues involves implementing technological and procedural improvements. Transitioning to electronic prescribing (e-prescribing) would significantly reduce errors associated with illegible handwriting and manual transcription. Integrating pharmacy systems with electronic health records (EHR) would allow direct transmission of medication orders, minimizing delays and transcription errors. Electronic MARs generated by the system would eliminate handwritten documentation, further reducing mistakes.

Adopting barcoding technology for medication administration can substantially enhance safety. Barcoding systems enable staff to verify medication and patient identity accurately before administration, ensuring the right patient receives the correct medication and dose. This technology further reduces the risk of medication mix-ups, especially when combined with electronic MARs. Additionally, transitioning from bulk medications to unit-dose packaging simplifies medication identification and tracking, reducing errors related to visual identification of medications.

Furthermore, training staff in medication safety best practices and fostering a culture of safety awareness are crucial. Regular medication reconciliation and audits can identify ongoing issues and help staff adhere to protocols. Incorporating medication safety policies into daily routines promotes accountability and continuous improvement.

The implementation of a barcoding system presents both advantages and disadvantages. Among the advantages, increased accuracy in medication administration, reduced medication error rates, and improved documentation are primary benefits. Barcoding also enhances accountability by tracking who administered the medication and when, which can be valuable during incident investigations.

However, there are notable disadvantages. The initial cost of implementing barcoding technology is substantial, including software, hardware, and staff training expenses. Resistance to change among staff may pose challenges, as adjusting to new workflows requires time and effort. Technical issues and system downtimes can disrupt medication administration, potentially causing delays or errors. Moreover, if not properly maintained, the system's reliability can significantly diminish its benefits.

In conclusion, addressing medication safety in this long-term care setting requires a multifaceted approach that includes technological upgrades, procedural reforms, staff education, and fostering a safety-oriented culture. While barcoding systems offer promising improvements in accuracy and safety, the decision to implement such technology should consider costs, staff readiness, and infrastructure readiness. By systematically reducing points of failure in medication processes, the facility can enhance patient safety and reduce the incidence of medication errors.

References

  • Holland, R., & Kelly, S. (2018). Improving medication safety in healthcare: A systematic review of interventions in long-term care. Journal of Patient Safety & Risk Management, 23(2), 55-62.
  • Kim, J., et al. (2020). Barcoding technology in medication administration: A systematic review. International Journal of Medical Informatics, 137, 104112.
  • Li, L., et al. (2019). The impact of electronic prescribing and medication administration systems on medication errors: A systematic review. Drug Safety, 42(1), 1–14.
  • Morden, N. E., et al. (2016). Medication safety in long-term care: A review. JAMA Internal Medicine, 176(6), 920–927.
  • Preston, C., et al. (2021). Implementation of barcode medication administration in nursing homes: Barriers and facilitators. Journal of Nursing Care Quality, 36(4), 291-297.
  • Rochon, P. A., et al. (2017). Medication errors in long-term care: An integrated review. The Annals of Pharmacotherapy, 51(10), 934-943.
  • Schumacher, P., et al. (2019). Strategies for reducing medication errors in nursing homes. Geriatric Nursing, 40(4), 391-398.
  • Tsang, C., et al. (2018). The role of electronic health records in improving medication safety. Electronic Medicine, 6, 23-29.
  • Wang, T., et al. (2020). The effects of barcoded medication administration systems on medication errors: A systematic review. BMC Medicine, 18(1), 117.
  • Zhang, Y., et al. (2022). Cost-benefit analysis of implementing barcode medication administration in nursing homes. Health Economics Review, 12, 8.

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