There were numerous reasons why a prescription was inadequate (Table 2), the most common being the wrong / lack of which eye the prescription was for followed by the wrong / lack of frequency specified.
At the end of the clerking proforma, the doctor completing the admission clerking for the patient is requested to document their designation and grade. We found that majority of the doctors did not complete this section; therefore to compare the prescribing quality of different grades of doctors we used the first 30 prescriptions chronologically completed by Foundation Year 1, Senior House Officer and Senior Doctors each. The highest error rates were amongst the Senior House Officers, followed by Foundation Year 1s and finally Senior doctors
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O or IU; 1 prescription specified a dose of 10mls to be administered, which was the size of the bottle rather than the dose; numerous glaucoma medications were prescribed as pro re nata rather than regularly; 1 prescription was illegible and not corrected even following pharmacists’ or nurses’ written prompts. The majority of prescription errors however were due to the wrong or lack of eye specified. The main reason for incorrect prescription of ophthalmic medications is probably unfamiliarity with the preparations in terms of the frequency of prescription and the different concentrations available. It can be hypothesized that eye drops are often not considered as medication, not only amongst patients but also amongst junior doctors. GP records do not specify which eye the ophthalmic medication is for and simply states ‘on affected eye’, which can be a concern for patients unable to communicate. Some doctors did not know that glaucoma can exist in one eye and therefore drops are supposed to be prescribed only for one eye. There was 1 case where a patient was seen in the outpatient ophthalmology clinic, found to have glaucoma and was started on regular Azopt and Ganfort. Within 3 days he was admitted with a urinary tract infection and by this time, his GP summary had not been updated with the new regular eye drops and therefore he was not prescribed these. This not only shows a failure in communication between GP and hospital prescribers, but also between doctors within the same hospital, especially when treatment is started by a different
Healthcare professionals must talk to their patients about possible side-effects of drugs they are taking and make sure they understand what can happen. In doing so, patients may start to understand why something is happening to them and it is a normal side-effect, which can not only lead to trust from the patients to providers, but can lead to the passing of knowledge from one to another which may prevent future
Doctor’s Diaries Worksheet What do you see as some of the stresses medical students deal with? How do they react to dissection of cadavers? During the film each student shared one common stressor, the work load. During the first two years of medical school, the work load is heavy, a lot of reading textbooks and memorizing material.
Physicians in the US are given the autonomy to prescribe to patients without restriction of drug indication as long as the prescribe drug is given to the patient to help with their ailment in good faith. Physicians give the prescription to the patient to get filled in the pharmacy. The retail pharmacist does not have instant access to their medical records to verify the indication. The pharmacist can verify the drug and the intent of the phycisian. Once confirmed, the pharmacist can fill the prescription regardless of efficacy of the drug on the patient.
(prescription monitoring program), but only 53% of them use it due to time-consuming nature of information retrieval and the lack of an intuitive format for data provided by the programs. State government should consider an implementation of legal mandates, as well as investing in prescriber education, and taking measures to enhance ease of access to and use of the programs.
Hi, this is Maggie Ganley. I hope everything's going well this year and none of your students are driving you too crazy. I can say that this school year has definitely been a whole new experience for me. The adjustment to college has been an interesting one but it's getting easier as time goes on, even if my calculus still class drives me crazy from time to time (the adjustment from high school Algebra II to college Calculus is a bit of a stretch).
Transitions in care, such as admission to and discharge from the hospital, put patients at risk for errors due to poor communication and inadvertent information loss (1–5). One discrepancy does not necessarily mean an error. In fact, most discrepancies are due to adapting chronic medication to the patient’s newly diagnosed condition, or because the examinations and/or interventions performed could interfere with their usual medication. Medication discrepancies, established as unexplained differences among documented drug regimens at the interfaces of care1 (admission, transfer, and discharge) are highly prevalent. Some are intended therapeutic modifications, but others are unintentional and clinically unjustified.
There are several ways these errors could have been prevented. The nurses should have done three different checks on the drugs with the medication administration record (MAR) and the patient. If they had done those checks properly, then the error could have been caught early. According to the report, the problem with the situation with the second patient was the doctor’s handwriting on the prescription. If the doctors would have made make sure their handwriting iwas legible, thanthen the second patient in this sad case may not have been a victim at all.
Medication errors can be very dangerous for the ones taking the wrong medicines or doses; therefore, safety measures must be in place. Administering them must be done with an understanding and focus. One missed check could have a staff member giving a resident the wrong set of pills. Some interventions to help prevent the medication error from occurring is to first report errors. When errors are reported, the main cause is to try and never let the error occur again.
Medication use is potentially dangerous. Polypharmacy is increasing, and makes it harder to keep track of side effects and interactions and of potentially inappropriate drug combinations. “The risk of serious consequences, hospitalization, and death due to medication errors increases with patients’ age and number of medications (Scand J Prim Health Care, 2012)”. For example, the GP is supposed to monitor the patient's regular medication, but does not always do so. Lack of monitoring and keeping track of patients’ medication use is a main cause when a patient is given inappropriate drugs.
A one on one talk with the pharmacist will enable a platform where the patient can clear their doubt and summarize their understanding of their prescribed medication. d. Most patients do not adhere to their medication due to the complexity of the dosage regime; in this, case the pharmacist can suggest that the prescriber breaks down the dose regime using medication cards or dosette to simplify the
Many policymakers are giving huge attention toward medical errors that affect patient safety improvements by redesigning the delivery of healthcare system and methods and preparing plans for any inevitable errors that might occur in future as these errors often lead to adverse healthcare events and could be considered as the leading cause death. The incidence rate of medical errors were not well known until many countries have reported in 1990s that a lot of patients have harmed and died by medical errors they faced. The most reported medication errors were: wrong dose, delayed medicine or treatment, and wrong medicine taken. (Patrick A. Palmieri, 2008). In Saudi Arabia a lot of medical errors incidences were reported which were one of the
It has been notice that medication error is a problem on our unit. By doing some research it was found out that between 48,000 to 98,000 hospitalized Americans die each year due to medical error. Of this number 7,000 deaths are attributed by medication error. These statistics only report hospitalized based and no other health care settings like ours. As a result of the increase medical error incidents the Florida Legislative passed law mandating all health care professionals to do continuous education courses per on year prevention of medical errors.
I agree with the way you are looking at the different points of view. I also want to bring to your attention the amount of medication the children are taking; the doses and the amount of different medications that are being prescribed. There have been studies where children are on more than one medication. There was an 18 month old that we put on antipsychotics for his severe temper tantrums. “By the age of 3, his drug regimen had expanded to include "the antipsychotic Risperdal, the antidepressant Prozac, two sleeping medicines and one for attention-deficit disorder.””
Medication errors are defined as faults in drug prescribing, transcribing, dispensing, monitoring, ordering, and/or administration. These errors have significant potential for injuring or even killing a patient. Discussed below is an article that highlights the dangers of inaccurate drug administration. A case was reported of a 7-year-old boy with Fanconi’s anemia that underwent a successful bone marrow transplant and months later returned to the hospital for a minor febrile episode. The night before his discharge he was given 3.5 gm/m 2 of cytarabine over 2 hours, which the nurse calculated according to his surface area.
Tolicia, I agree that getting patients involved in all aspects of their care would greatly reduce the number of medication errors. If a patient knows what their medication looks like, what time they take it, what route it is administered, and what it is for, then this will protect them from receiving the wrong medication. Encouraging patients to get involved in their care would also present more opportunities for patient education and it would allow the patient to ask any questions they may have about their condition, and to mention any side effects or new problems they are experiencing. Urging patients to speak up about their medication administration could also allow the doctors and nurses extra opportunitites to evaluate if the medication