When an elderly individual enters a nursing home, he or she hands over the control of his or her medication to nursing home staff. That staff is then required to give the correct drugs at the correct doses at the correct time(s) each day. The failure to administer that medication properly is an act of nursing home neglect.
The Prevalence of Medication Errors in Nursing Homes
The National Coordinating Council for Medication Error Reporting and Prevention defines medication errors as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer.”
In 2000, a study of 18 nursing homes in 2000 found that nursing home staff in Massachusetts inappropriately administered more than 20 percent of all medications. Proper care, treatment and oversight by nursing home staff could have prevented approximately 51 percent of those mistakes, or adverse drug events. If you apply those numbers to the nursing home population in the country today, then approximately 350,000 adverse drug events occur each year.
The Cause of Adverse Drug Events
Common adverse events include:
- Prescribing errors
- Wrong dosage
- Missed dosage
- Wrong drug
- Expired medications
- Incorrect administration
- Inadequate food and/or fluids with drugs
- Failure to monitor
One cause of these events is understaffing at nursing homes. Understaffing leads to oversight, hurried ordering and the inability to monitor every patient as necessary. Another cause is plain carelessness. If an orderly, nurse or doctor fails to pay proper attention to the medications he or she is administering to each nursing home resident, errors will follow. There are several other warning signs of neglect as well.
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Medications With the Most Errors
Based on the 2000 study mentioned above, it appears that nursing home staff makes the most medication mistakes when it comes to anticoagulants, or blood thinners, and psychoactive medications. Psychoactive medications include:
- Antidepressants
- Antipsychotics
- Sedatives
- Hypnotics
It is important to remember that any drug administered at the wrong dose or given in a way that does not comply with label instructions and warnings can lead to an adverse event, including serious injury, illness or even death.
Repeat Medication Errors Require Special Attention
A study published in 2010 in the American Journal of Geriatric Pharmacotherapy noted that more than one-third of all medication errors in nursing homes were repeat errors. The two actions that led to the most repeat errors were giving the wrong dose and administering the drug incorrectly. The potential for actual harm to residents doubled in instances of repeat errors.
If your loved one has already experienced one medication error while in the nursing home, you must take all steps possible to ensure the staff avoids further errors. Visit the nursing home during times when your loved one takes his or her medication. Ask the staff to carefully document every medication they give, including times and doses. Furthermore, make it clear to the nursing home staff and administrators that you will not tolerate any errors.
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