Hospitals Work To Correct Medication Inaccuracies

SEBRING - Nobody wants to skip even a single dose of prescribed medication when hospitalized.
And local medical staffers work to ensure that when a patient is admitted to the hospital they receive the correct medication and the proper dosage.

Donna Snyder, vice president of patient care services at Florida Hospital Heartland Division, said one of the first tasks, after a patient is admitted, is for staff to reconcile medications.

"It's like reconciling your checking account," said Snyder. "You figure what's in there and what you spend."

Highlands Regional Medical Center also is discussing ways to prevent accidents due to incorrect prescription information from patients. One employee suggested anyone coming to the emergency room should bring all of their prescriptions so nothing is missed, and dosage and drug names are verified.

Bob Brooks, staff pharmacist at HRMC, said hospitals must be extra careful with "look-alike, sound-alike medications."

Capital letters, or the use of "tall lettering" is used to determine between similar spelled drugs. He gave examples of two similiar-sounding and similar-spelled medications: HyDROXYzine, a medication for motion sickness and HyDRALAzine, for high blood pressure.

Within two to three years, Brooks expected that community hospitals will also use technology already available in some military medical centers for the past 10 years - a bar code system. Before a nurse would give a patient a pill, bar codes on a patient's wrist and for a specific medication would need to match.

Whether a patient is admitted through the emergency room, or through direct admission by a physician, they are asked to list which medications they are currently prescribed and the dosages.
But many patients can't always supply all the needed information about those medications.

"We encourage them to bring their medications with them to get it as accurate as possible," said Snyder. "We take patient safety very, very seriously. And we apologize if it seems we're asking way too many questions."

Doctors also work to ensure that newly prescribed medications don't interact. Sometimes a physician needs to change or eliminate existing medications during a hospitalization.

The Joint Commission for the Accreditation of Hospitals performs unannounced inspections at hospitals every three years to ensure National Patient Safety goals are followed.

Those goals, as updated January 2007, state the purpose of reconciliation of medication is to "avoid errors of transcription, omission, duplication of therapy, drug-drug and drug-disease interactions."
People are living longer and there are many more medications than ever.

"As medicine has advanced, the number of drugs has increased," said Snyder.

Snyder suggested that area residents be prepared in advance, just in case.

"Everyone should line up all medications, write down all the names and carry a list in their wallet," said Snyder. "It's a good head start ... and in an emergency situation, some may forget because they are anxious."

Howard Pritchett, pharmacy director at Heartland Pharmacy, said most pharmacies can help prepare a customer's list of medications.

"Although it keeps changing," said Pritchett, "it's a good idea with core medications for high blood pressure and diabetes to have a print-out. Most pharmacies have the ability to provide a list to be put in a wallet or a purse."

After being discharged from the hospital, patients should receive a single, clear and complete list of medications.

"The discharge medication list should include not only the medications that are prescribed at the time of discharge, but any other medications the patient/client/resident will be taking, including over-the-counter meds, vitamins, etc..," reads the joint commission's patient safety goals.