Skilled Nursing Articles
Addressing Top Medication Safety Issues In Long-Term Care FacilitiesNovember 10, 2020
There are numerous factors to consider when evaluating medication safety in long-term care facilities. While each carries their unique risk to resident well-being, the most common risks are:
- Opioid Abuse: A topic of great concern in recent years is the rate of which opioid use, misuse, abuse and addiction has increased in older adults. A recent study in the Journal of the American Geriatric Society found that there are documented risks among this older population, including falls and fractures.
- Drug-to-Drug Interactions: It is not uncommon for LTC residents to be given multiple prescriptions to treat a myriad of medical conditions. The combination of multiple medications, polypharmacy, can often result in serious or life-threating drug interactions.
- Unnecessary Medications: According to a recent Human Rights Watch report, it was revealed that more than 179,000 residents in long-term care facilities were given medications without a proper diagnosis or prescription.
- Drug Diversion: Without safe storage and secure access, LTC facilities may experience decreased medication availability for residents, which can have a negative impact on those with excruciating pain that need instant relief.
- Overuse of Antibiotics: Prescribing practices that don’t follow proper guidelines can cause overuse of antibiotics, which in turn can result in severe consequences for residents of LTC facilities, including infections like C. Difficile and the development of antibiotic-resistant bacteria strains. *
- Incorrect Administration: Of the adverse drug events that occur each year, the Agency for Healthcare Research and Quality found that up to 60 percent are caused by administrative issues. Overwhelmed staff, inefficient computer systems, and lack of secure storage may all contribute to medication mix-ups or misadministration.
A 2014 study by the Office of the Inspector General indicated that 22% of Medicare beneficiaries in skilled nursing facilities experienced an adverse event during their stay, with more than half of them being preventable.
Steps to Prevention
A critical step in ensuring safe medication procedures are followed in long-term care facilities is the use of consultant pharmacists, according to a study in Therapeutic Advances in Drug Safety. These consultant pharmacists can help ensure safe outcomes for residents through optimal medication management by finding appropriate pharmaceutical solutions to suit the individual needs of residents, and providing in-service training and educate the staff on medication-related topics.
Additional opportunities that are available to improve prescription drug safety are the use of e-prescribing, electronic alerts and reminders, and automated dispensing.
Cultivating a Safety Culture
Ultimately the greatest chance for sustainable improvement to medication safety is the cultivation of a safe environment. Shifting from an environment of blame and discipline – which can reduce the rate of incident reporting – to one that takes a proactive approach to resident safety while empowering staff is key. A combination of multiple strategies can be effective in this effort, including focusing on early interventions, staff engagement, and improved communication protocols between nursing staff, physicians, and pharmacists.
With nearly a quarter of Medicare beneficiaries experiencing an adverse event during their nursing home stay, prevention is key in these complex settings. To learn how PharMerica can help you improve medication safety and outcomes, contact us at [email protected] or 855-637-1755 to learn more.