Medication errors harm at least 1.5 million people every year, according to the Institute of Medicine of the National Academies. Many of these cases occur in nursing homes and other long-term care facilities, where the task of preparing medications for many patients at once often means that each patient’s medications are not carefully checked to ensure they are correct.
What Is a Medication Error?
The term “medication error” describes a wide range of problems with administering medicine to nursing home patients. In any setting that involves prescription medications, a mistake may be made by a doctor who prescribes or orders a medication, or by pharmacy staff who misunderstand a prescription or who fill it with the wrong medication or the wrong dose, or by nursing staff who fail to administer it properly.
In a nursing home, patients may face a medication error such as the following examples:
- The medication is mislabeled with the wrong patient’s name.
- The medication is not given on time or a dose is skipped altogether.
- The wrong dose (too much or too little) of the medication is given.
- The medication is given to the wrong patient.
- If the medication is administered through an IV or a feeding tube, the correct procedure for administering it is not carried out.
- Instructions on the medication itself (shake well, take with food, do not crush, etc.) are not followed.
- The medication has expired.
Any of these errors can cause serious harm, especially when they are repeated over time.
What Causes a Medication Error?
Just as there are many types of medication errors, there are also many ways a mistake can be made. Some of the most common ways medication errors occur in nursing homes include:
- Transcription errors. The medication, dose to be given, schedule or method of administering the medication are written down incorrectly. When a nursing home makes notes in several places or transfers medication duties among staff members, transcription errors are more likely.
- Frequent distractions or care changes. Ensuring that medication is given correctly requires concentration, knowledge of both the medications and the patients, and attention to detail. When staffers are frequently interrupted while preparing or giving out medication, errors are more likely. They are also more likely to occur if staff members are frequently rotated through the position of administering medication.
- Improper training or inadequate information. If the nursing home staff does not have proper training for administering the medication, or if they do not have all the information they need to make sure each patient receives the correct medication at the right time, serious errors can easily result.
- Poorly scheduled medication dispensing times. A medication dispensing time that occurs during a shift change, mealtime or when the nursing home is understaffed increases the risk of an error, because it imposes additional distractions and stress that can affect the staff’s ability to ensure medications are administered correctly.
Nursing Home Medication Errors by the Numbers
A study in the American Journal of Geriatric Pharmacotherapy examined 15,037 medication error reports from 294 nursing homes. The study revealed the following facts:
- The most common errors were providing the wrong dose (65.1 percent) and administering a medication to the wrong patient (10.2 percent).
- More than 1 in 3 of the errors (37.3 percent) were repeated more than once. On average, a single mistake was repeated over 10 times before it was finally corrected.
- Older patients or those with cognitive impairments were twice as likely to experience a medication error as younger patients or those who could identify their own medications.
- A repeated error was twice as likely to cause harm to the patient as an error that was made only once.
How Can Families Help Prevent Nursing Home Medication Errors?
Over half of all medication errors in nursing homes are preventable, according to a recent ProPublica article. If your loved one needs care from a nursing home or similar facility, you can help reduce the risk of a medication error by:
- Asking about medication procedures. Who is responsible for administering medications? What training and education do they have? When is medication given, and how? Asking helps you determine whether the system is well-run, and it demonstrates to the nursing home that you take medication risks seriously.
- Timing your visits to coincide with medication times. If you’re present while medication is being administered, you can watch the process yourself. If your loved one is on three different medications, does he or she receive all three? If one or more needs to be taken with food, is food provided?
- Double-checking with doctors and pharmacies regarding your loved one’s medication. If you accompany your loved one to doctor’s appointments, make sure to review the medications with the doctor at each visit. If the doctor orders a new medication, double-check with the nursing home to make sure the prescription was received correctly.
If your loved one has been harmed by a medication error or other form of negligence in a nursing home, you should consult a qualified Washington DC nursing home negligence lawyer as soon as possible. You may be entitled to significant compensation.
- American Journal of Geriatric Pharmacotherapy – Repeat medication errors in nursing homes: Contributing factors and their association with patient harm
- ProPublica – One Third of Skilled Nursing Patients Harmed in Treatment