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Take the lead in PCA safety: How pharmacists can improve patient outcomes

Accreditation Connection, January 14, 2005

Patient-controlled analgesia (PCA) can be an effective way to treat a patient's pain, but be aware of issues that may threaten patients' health and safety.

Research conducted at the University of Pittsburgh Medical Center has shown that if the wrong patient population is selected for a certain drug, such as Demerol in a PCA pump, the patient is at higher risk of experiencing an adverse drug event, says Robert Weber, MS, the facility's executive director and department chair of pharmacy and therapeutics.

Also, some patient populations may receive a higher dose than what is considered safe for them. To prevent this, for example, healthcare providers can prescribe lower than normal doses of morphine for elderly patients or those with renal failure.

Pharmacists can ensure that prescribers write the medication order correctly and that the order is dispensed properly, Weber says. Pharmacists must then make sure that nurses completely understand the therapy prescribed, he says.

Nurses might ask questions about orders, including how they are written, so pharmacists must be able to explain orders or know where to find the answers.

The University of Pittsburgh Medical Center requires PCA competency assessments for pharmacists, says Weber. Pharmacists must take tests to indicate that they understand the concentrations of medications, the doses for different patients, and to assess their competency in PCA pump operation, he says.

Tip: Observe pharmacists processing PCA medication orders.

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