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Reducing the risk of medication errors

Long-Term Care Nursing Advisor, September 8, 2006

To reduce medication-related safety problems, consider the following:

• Accurately follow the facility policies and procedures, physicians' orders, and pharmacists' recommendations for medication administration. Contact the ordering physician if you have a question, problem, or concern. Use the pharmacist as a resource.
• Identify risk factors for safe medication administration, including a decrease in the ability to chew and swallow food or fluids, neurological and muscular deficits, oral health status, tube feeding, side effects of medications, or improper positioning. Consider risk factors when administering medication, and meet the resident's individual needs.
• Some residents receive medications such as insulin or warfarin based on certain laboratory values. Monitor the results of laboratory or point of care testing closely. Know the implications of abnormal laboratory values. Inform the physician of complications, problems, or abnormalities. If you fax abnormal laboratory values to the physicians' office, always follow up with a phone call. Document the fax and phone contact.
• Document administration of the medication on the medication administration record immediately after giving the scheduled dose. Never document medications in advance. Never document medications when the resident is in the hospital. Write a narrative description of special circumstances, complications, or problems encountered during medication administration. If the resident refuses medications, circle your initials in the administration box, and write a narrative note describing the circumstances of the refusal.
• Assess the resident and notify the physician of missed doses, side effects, drug interactions, abnormal laboratory tests, problems, or complications related to administration of medications.

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