How hospitals can ccntrol a patient’s home medications

Accreditation Connection, October 24, 2005

Knowing how your hospital controls a patient's home medications will help when a patient brings drugs into the facility and needs to use them.

"We would rather not use a patient's home medications in the hospital," says David Kellogg, DPh, MS, pharmacy director at Tennessee Christian Medical Center in Madison, TN. "We don't know how they are stored or where [the patients got them]."

But in some instances, such as during drug shortages or in the case of expensive HIV or other drugs that the pharmacy may not stock, using a patient's own medications is inevitable. JCAHO standard MM.2.40 requires hospitals to create a process to safely manage medications patients or their families bring to the facility.

Kellogg offers some strategies:

Take control. The Tennessee Christian pharmacy controls all patient prescriptions, meaning that patients do not keep medications in their rooms. Pharmacists handle the dispensing of all medications, including the patient's own from home. Medications are arranged by patient's last name and placed in file cabinets in one area of the pharmacy. The drugs are considered to be in a secure area because the pharmacy is locked at all times.

Nurses at Reedsburg (WI) Area Medical Center collect all patient medications if they must be used, says Linda Chickering, RPh, the clinical pharmacy director.

Know what they are. Pharmacists must verify every medication a patient brings in from home. After pharmacists visually verify the drug, they place their initials and date on the bottle sticker, and they must also obtain an order for the patient's medication from the physician for it to be used in the hospital.

Get a receipt. A three-part form helps Tennessee Christian staff document receipt of a patient's home medications. When a patient brings prescriptions from home, nursing staff collect them and sign the form, send the medications to the pharmacy, and then a pharmacist signs the form. The patient or a family member must also sign the receipt. The pharmacist staples a copy of the form to the bag with the medications, sends one copy to the patient's chart, and gives another copy to the patient. When the patient is discharged, the nurse takes the forms to the pharmacy and exchanges them for the patient's medications.

Adapted from the October issue of Hospital Pharmacy Regulation Report.

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