The typical process of medication management within residential aged care is complex and requires many essential steps, various information sources and the involvement of internal and external healthcare professionals.
Strengthening these interdisciplinary partnerships and streamlining the workflows that support medication administration will play a critical role in protecting elderly residents from adverse medication events caused errors.
According to a report released by the Australian Institute of Health and Welfare, 39,466 people admitted to hospitals from residential aged care facilities, 30 percent were admitted as a result of adverse medication events. A significant amount of these errors – around 75 percent – were potentially preventable.
Preventable medication errors and discrepancies in residential aged care are caused by a combination of factors. According to Electronic Medication Management in Aged Care, over 90 percent of the population over 65 will have taken some form of medication within any two week period. Residents of aged care facilities are also commonly prescribed multiple medications at the same time, given their complex health conditions.
In a 2010 study, Sommers et al identified polypharmacy – the concurrent use of five or more medicines – in 91.2 of the residential aged care facility residents, with an average of 9.75 medicines per person. Using this statistic, it is reasonable to assume that, on average, a 100 bed facility would be administering about 1,000 medications to residents per day, while a 1000 bed organistion would be administering up to 10,000 medications per day.
Now consider that the primary tools being used by the majority of aged care providers to manage their residents’ medications still revolve around paper-based systems with significant limitations. It becomes very challenging to provide the highest levels of safe and quality care, while using a manual approach to administer such large volumes of medications.
The new era of electronic medication management
An upward trend has occurred over the past few years, where we have witnessed a greater number of residential aged care providers seeking to improve medication management processes. By restructuring and investing in electronic medication management (EMM) systems, many providers are achieving an immediate and substantial reduction in preventable medication errors.
Apart from the obvious need to reduce the risk of harm to residents, implementing EMM systems within residential aged care can result in organisation-wide efficiencies. Below we have outlined five ways that your organisation and its employees can enhance medication administration outcomes with the implementation of EMM.
Reduced compliance risks
In a typical residential aged care setting, the method of administering medications to residents takes place in the midst of a lengthy, demanding and often disrupted medication round. Not only do these distractions negatively impact staff productivity, they can also lead to serious compliance risks including signature omissions.
Eliminating signature omissions is a critical part of maintaining compliance, and can be achieved instantly with the implementation of an EMM system. An EMM system outperforms a paper-based system in this regard, with configurations that prevent staff from proceeding with medication administration until a signature has been recorded. Intuitive alerts prompt staff to log onto a mobile device at the point of medication administration, ensuring that the medications to be administered within a given time period are electronically tagged with a date, time and signature.
These embedded safety alerts further support accreditation requirements by enforcing the six Rs of correct medication administration – right resident, right medication, right route, right dose, right documentation and right time – and confirming that the welfare and rights of the resident receiving the medications remains the priority throughout the entire process.
EMM also enables aged care providers to safeguard their organisations against compliance risks associated with the administration of PRN ‘as required’ medications. An EMM system prompts staff to enter the reason for why the PRN was administered. In instances where EMM integrates with an electronic clinical system, this information is also automatically recorded within a progress note to ensure more effective evaluation of PRN medications.
Read part two of this series to find out how aged care organisation can use EMM systems to increase efficiency and productivity; reduce pressure on registered nurses; enhance governance and decision making; as well as improve daily experiences for staff.