Preventing Medication Errors

WHY THIS IS SUCH AN IMPORTANT TOPIC

Preventing medication errors should be a top priority for every caregiver.  The US FDA reported that medication errors cause at least one death every day.  In addition, it’s estimated that medication errors cause injury to approximately 1.3 million people yearly, just in the United States alone.  It’s important to note that medication mishaps can occur anywhere along the distribution system — from the doctor’s prescription, the pharmaceutical company, the pharmacist, to the person administering the medicine (in many cases, this is you). 

WAYS TO LESSEN THE RISK OF MEDICATION ERRORS

Use only one pharmacy if possible

The pharmacist will have a record of all your prescriptions and therefore be better able to spot possible drug interactions and will notify the doctor of this.  Be sure to tell the pharmacist about any over-the-counter drugs or herbal medicines being taken.

Learn as much as you can about each drug

Purpose:   This should be written on the prescription label and should coincide with what the doctor told you.  You could also look it up on the internet, at the library, or in a Physician’s Desk Reference.

Size,  Shape,  Color:  Pharmacists can make mistakes, too.  If the pills look different, check the label to see if they’ve changed brands.  If there’s no notice to that effect, notify the pharmacy and hold the meds until you get an answer.

Possible side effects:   Learn what to look for and know what to do should this occur.  A medication data sheet should be included with your Rx.  If not, call the pharmacy for that info.

Special storage requirements:  Check the label for specific directions.  Examples: refrigeration, out of direct light, away from heat, etc.

Dosage

Some doses may have to be cut in half.  If so, ask if the pill comes in a lower dose to minimize crumbling and loss of medication.  If not, request a pill cutter.  You can also ask the pharmacy to cut them for you.


Be sure to ask the following questions about the drug:

What are the side effects, and what action is needed? 

What action is required if a mistake is made?

How many times a day should it be taken? 

Do the doses need to be evenly spaced?

What if a dose is missed — take it asap or skip it?

Should the medicine be taken with food or on an empty stomach?

Is alcohol allowed while on this medication?

Can the medication be crushed if necessary?


 

Liquid medications come with their own dispenser (syringe, spoon, small cup, or eye dropper).  Use the dispenser only for the medicine it came with.  Ask the pharmacist to make a mark on the dispenser indicating the correct dose.  Clean them after use (except for the eye dropper – you don’t want to dilute the medicine, and be careful – the dropper should not touch the eye when administering drops).

Pain medication should never be increased in dosage or frequency without first getting authorization from the physician.

Ask how close pain medicine may be given with sleep meds or tranquilizers.

Never share or borrow medicines from others.

Keep medicines out of reach of children and anyone exhibiting signs of confusion or suicidal tendencies.

Administer antibiotics for as many days as prescribed.  Do not stop taking them because symptoms are subsiding; the full course is required.

PILL ORGANIZERS

Weekly Pill Box Organizers

As you enter pills into each slot, check and double check the medication name, dose, and times against your medication schedule*.

I recommend a separate pill box for each time slot.  Label each box as Breakfast, Lunch, Dinner, Bedtime, etc.  As the pills are taken for that time slot, the box is placed in the cupboard or behind the others, so the next up will be front and center.

Monthly Pill Box Organizers

There are larger pill organizers, some for the entire month, and some for one week with four rows to accommodate different times of the day.  This might look convenient at first glance, but I personally discourage their use for the following reasons:

If the user is prone to confusion, this system can be overwhelming.

Some meds may not belong in the preprinted time slots.

Meds may be discontinued, or dosages changed after the meds have been set up.  Many drugs look similar, and the wrong one could easily be pulled out while trying to introduce the modified dose.

You may not have enough pills for the entire month before a refill is due.  Trying to remember where you left off adds stress and a greater chance for errors.

Imagine the consequences if the box is dropped and pills spill out everywhere…


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* I’ll address how to set up a medication schedule in a future post.