One of the most common types of mistakes in health care has to do with medication errors – when patients take too many, too few, or the wrong medication.  Medication errors can be very serious and lead to serious complications, admission to the hospital and in the most extreme case, even death.  Medication errors may occur outside the hospital when patients don’t follow instructions for taking their medication or inside the hospital when information doesn’t get relayed accurately.  The good news is that patients and family members can help prevent many of these medication errors.

Medication errors often occur at “transition points,” such as when patients enter the hospital, move from one facility to another, or leave the hospital to go home.  Another time that is prone to errors is anytime medications are started or stopped.  A new national initiative to reduce errors at these transition points is occurring in most health care organizations.  “Medication Reconciliation” is this process. A patient’s home medication list is reviewed and compared to what the physician has ordered.  This will eventually occur in all patient care settings, whether inpatient, outpatient, emergency, long term care, or home care.   

There are some ways YOU can help complete the Medication Reconciliation process and help prevent medication errors.  You can help to prevent errors by knowing about the medications you take.  This is easiest to do by making a list of all your medications.  Your medication list should include:  (1) names of all your medications, (2) dosages, (3) the times you take each medication, (4) the way you take each medication, (5) why you take the medication and, (6) any allergies and intolerances, and the reaction you experienced. 

Be aware that most medications have a brand name and a generic name.  The brand name is usually easier to remember.  Spell the medication name correctly as there are many look alike and sound alike medications.  Your medication list should include ALL the medications that you take, including herbals, vitamins, eye drops, patches, ointments, inhalers and over-the-counter medications like antacids, laxatives and analgesics.  It is important to list the number of tablets, capsules, puffs, or drops you take at one time.  Some medications are to be taken before you eat, with food, the first thing in the morning or at bedtime.  Be sure you know any special instructions about each medication that you take.  As previously described, medications have different routes or ways they are taken.  Some are swallowed while others are inhaled or rubbed on a particular area.  Finally, list why you take each medication.  Some medications have dual purposes and can treat different problems.  For example, describe whether you take a medication for “sleep”, “depression”, “breathing,” “high blood pressure”, etc.

Make sure to keep your medication list current.  Change the information on your list each time you start or stop taking a medication.  Obtain your prescription medications from one pharmacy.  Ask your pharmacist to review your medication list and make any needed changes according to what your doctor has ordered.  Bringing your medication list to all your clinic appointments allows your doctor and nurse to review the medicines you are taking, should be taking, and any over-the-counter medications you take. 

Bring your medication list each time you go to the hospital, emergency room, or clinic.  If you are admitted to the hospital, it is helpful if your medication bottles are brought in so the labels can be compared with what your doctor has ordered.  Tell your family, friends and neighbors about the benefits of creating a medication list.  There are many resources available for making your home medication list.  You can find one form on this website by clicking on this link.  c:\home medication form 5-06.doc

By creating and using a home medication list, you can reduce confusion and save time because you do not have to remember all the medications you are taking – the list does this for you.  A home medication list provides doctors and all health care providers with a current list of ALL of your medications, thereby improving communication.  Medication safety is improved because medication interactions and duplications can be easily detected and corrected. 

There are other actions you can take to assure safe medication use both inside and outside of the hospital.  All patients should know that they have an important role and responsibility for ensuring their own safe care.  If at any time something doesn’t feel right, or if you’re unsure about something, speak up!  You have the right to ask questions.  If you feel any medication is making you sick, causing you pain or other side effects, report it immediately.  Hospital staff should check your wrist band and ask your name to confirm your identity before administering tests, providing treatments, drawing blood and giving medications.  If you are given a medication in the hospital, make sure you know what it is and why you need it.  When you go home from the hospital, get your health care instructions in writing and make sure you understand how to follow them.  At home, medications that have expired or those you haven’t taken for 1 year should be thrown out.  Medications you are not currently taking should be placed in a separate location (a baggy labeled “do not take” works well too).  Never take medications that were not prescribed for you.  And finally, all medications should be kept out of reach of children.

Remember, safe medication use is a partnership between you and your healthcare provider.  When you take an active role, your outcome is likely to be better.

Author:

Mercy Hospital Safe Medication Practices Team