Predictors of Medication Errors in Elderly in Nursing Homes - Research Paper Example

Predictors of Medication Errors in Elderly in Nursing Homes Introduction The improvement of health among patients is increasingly growing to becoming a basic fundamental human right of all people. For this reason, when people visit the hospital, they expect nothing more than the improvement of their health. Sadly though, it is not always that this noble aim gets achieved. One outstanding factor that leads to the failure of this all important healthcare expectation is medication error. Medication errors occur when drugs are administered either in a wrong proportion or of the wrong purpose to patients. In this end, the National Coordinating Council for Medication Error Reporting and Prevention (2011) explains that "A medication error is any preventable event that may cause or lead to inappropriate medication use while the medication is in the control of the health care professional, patient, or consumer.” This means that medication errors do not only occur at the hands of medical professionals. In this essay, the writer review predictors of medication errors in elderly in nursing homes. This means that the bulk of the writer’s attention shall be based on factors that medical practitioners in nursing homes and taking care of elderly people can use to predict possible medication errors. As seen in the definition of medication errors, the writer’s view of predictors shall be varying and widespread, not centering only on the health practitioner but on all other causative factors including patients and consumers. Predictors of Medication Errors in Elderly This section of the essay reviews five major predictors of medication errors that can take place among elderly people in nursing homes. Number of Home Medications The fact that elder people under consideration are based on nursing homes should not eradicate the possibility of medication error occurring as a result of number of home medications. Nursing officers and other health professionals taking care of elderly people in nursing homes must predict the fact that once admitted at the home, the history of number of home medications received by patients before their admission at the nursing home can interfere with the efficacy and functions of medications administered to them at the nursing home. For this reason, it is rightly appropriate that nursing and other health professionals have fair idea of medications patients on admission might have received at home before being admitted. Over the years, it is because nursing practitioners have been negligent of the need to assess the number of home medications taken by elderly patients admitted at the nursing homes that Prasanatikom and Madigan (2004) concluded in a research that “incidence of medication error was highest at the first visit (23.5%)” Self-administration of medication Self-administration of medication is something that is common among elderly patients in nursing homes. Pollick explains that self-administration of medication or self-medication is the “practice of using illicit or legal drugs without proper medical supervision is known as self-medication.” The commonest cause given to the problem of self-administration of medication among elderly patients in nursing homes has been found to be over anxiety among the elderly patients (Akakpo, 2003). As a matter of fact, due to degeneration psychological problems among elderly patients, they tend to be very anxious about their health and always have a feeling that taking medications in overdose or taking extra medications aside what is prescribed for them may lead to quick recovery of their health. Health practitioners in nursing homes must therefore have a forecasted knowledge that if self-administration of medication takes place among their patients, the patients risk the problem of medication error because there is the tendency of self-medicated drugs conflicting with the functions of prescribed drugs. Evaluation of discharge planning The practice whereby discharging patients in nursing homes are poorly evaluated can is a predictive factor for medication error. This is because upon wrong or poorly administered discharging evaluation, nurses and health professional are likely to prescribe wrong after-in-house drugs for patients. Such wrong after-in-house drug prescription may either be estimated below what patients require as they leave the nursing home or above what they need after leaving the nursing home. In this direction, there are models that have been identified as most appropriate for undertaking effective evaluation of discharging planning. For instance the Franciscan St. Elizabeth Health (2011) advocates proper discharging planning and evaluation to include assistance related to: “Admission screening and evaluation of discharge needs; Coordination of home care planning; Transportation; Equipment for the home; Referral to community agencies/resources and Nursing home placement.” When all these interventions are duly given out and considered in the evaluation of discharging planning, nurses and health practitioners are going to be in a better position to monitor their medication habit and thus avoid possible medication errors. Over-the-counter medication The occurrences of over-the-counter medication have a very high risk of leading to medication errors. This is because of the possible event of interference of over-the-counter medications with prescribed medications from the nursing home. In most events of over-the-counter medication, the pharmacists or drug givers do not have a better understanding of the history of the patient or medications already administered. For this reason, the pharmacists or drug givers give out drugs without thinking of the possible effects in the long term. Once patient who might have used over-the-counter medications are admitted at the nursing home with such history of over-the-counter medication, health professionals at the home risk involving themselves in medications errors because of such history of patients. It has even been established that in some cases, elderly patients in nursing homes find their way to using over-the-counter medications through the conniving assistance of relatives. Reasons why this would happen still boil down to anxiety by the elderly patients to get well at a faster rate. RN staffing changes Another important predictor of medication error pointed out in a research by Debra et al (2008) is registered nurse staffing changes. The research asserts that change in hands as far as nurses in charge of the medication care of specific elderly people in nursing homes take place, there become the probability that health records alone cannot give incoming nurses fairer idea of where and how to continue administering medications in such a way that it would not lead to medication errors. Most often than not, it do not take only the records in the medical books to determine the best line of drug administration for particular patients. The little lapses and adjusts taken by caring nurses for patients are not documented and so when nurses are changed, they lack knowledge of the unrecorded data and thus risk giving new medications that may result in errors for patients. Debra (2008) therefore suggests an effective handing over model for transferring nurses stating that “further validation of this explanatory model and focused interventions may help decrease the incidence of medication errors.” Importance of Identifying Predictive Factors for Medication Errors Ben-Yehuda et al. (2011) lament with surprise that “medication errors are the cause of common and dangerous adverse effects on patients.” Such is danger that medication errors among elderly patients in nursing homes can bring. Nurses and all other healthcare agents and stakeholders are therefore admonished to be in a position to understand the dangers and therefore put in place measures to avoid medication errors. The identification of predictors of medication errors is an important step to take in the fight against medication errors. This is because once these predictive factors are known health practitioners always look out for these factors and try to avoid their occurrence in the nursing home. Without the knowledge of any risk factors, nurses and healthcare stakeholders would be working from an uninformed point of view and become culprits of the otherwise avoidable medication error menace. Conclusion It is good to have noted earlier that medication errors are avoidable. The essay would therefore be ended on a note of encouraging nurses to always to be on the look out for factors that will help them reduce or avoid the problem of medication errors. Advocated research should therefore continue to always expand the knowledge of nurses on how they can identify predictive factors leading to the cause of medication errors. REFERENCE LIST Akakpo G. R. (2003). Nursing Care for the Elderly in Nursing Homes. Academic Press Limited: New York Ben-Yehuda et al. (2011). Risk Factors for Prescribing and Transcribing Medication Errors among Elderly Patients during Acute Hospitalization: A Cohort, Case-Control Study. Drugs & Aging Journal. Volume 28 - Issue 6 - pp 491-500 doi: 10.2165 / 11590610-000000000-00000 Debra et al. (2008). Predictors of Medication Errors Among Elderly Hospitalized Patients. American Journal of Medical Quality March/April 2008 vol. 23 no. 2 115-127 doi: 10.1177/1062860607313143 Franciscan St. Elizabeth Health (2011). Social Work / Discharge Planning. Retrieved October 28, 2011 from http://www.ste.org/DesktopDefault.aspx?tabid=105 National Coordinating Council for Medication Error Reporting and Prevention (2011). What is a Medication Error? Retrieved October 28, 2011 from http://www.nccmerp.org/aboutMedErrors.html Pollick M. (2011). What is Self Medication? Wise Geeks. Retrieved October 28, 2011 from http://www.wisegeek.com/what-is-self-medication.htm Prasanatikom W. and Madigan A. E. (2004). Predictors of Medication Administration Error in Elderly Home Care Patients. Retrieved October 28, 2011 from http://stti.confex.com/stti/inrc15/techprogram/paper_17997.htm Read More