Improving the management of medicines within aged care is a national safety and quality priority.
As more of our ageing population live independently and in their homes for longer, the people entering residential aged care facilities are now frailer, more vulnerable and reliant on others for their basic needs. And as our ageing population grows to become older and frailer, there are more residents with complex and chronic co-morbidities who require a wide range of care and support services, with intricate medication regimes to suit.
The use of multiple medications by residents – the average older person is taking seven to eight medications at any given time – increases the risk of medication-related adverse events. Medication errors continue to be a major problem in aged care, and can occur as a result of failures in prescribing, dispensing, administering, managing or monitoring residents’ medication. These faults continue to put the residents’ safety and wellbeing at risk and have serious consequences for the elderly. In this context, the processes aged care providers employ to manage increasingly high rates of polypharmacy must evolve to support the enhanced safety of residents.
The majority of medication errors are preventable, with the right system in place. Below we explore the ways that electronic medication management solutions can ensure the principles of the six Rs of correct medication administration – right resident, right medication, right route, right dose, right documentation and right time – is not compromised.
Hand written, paper-based medication charts are widely recognised as a source of error in aged care. Illegibility can increase the chance of the wrong medication being prescribed, dispensed and administered.
Medication management systems that support electronic medication charts can significantly reduce errors associated with illegible handwriting, unclear terminology, and the other common breakdowns in communication caused by paper-based systems. Electronic medication charts centralise all medication information in a clear and concise manner to provide a single source of truth, with accurate and timely data available to ensure the right medication is given to the right resident. In this aspect alone, electronic medication management systems greatly reduce the scope for medication errors and contribute to enhanced resident safety.
Some of the most common errors linked to medication administration within residential aged care include incorrect dose or timing, distraction when administering medications, lack of knowledge about how to administer correctly, lack of supervision and signature omissions. Electronic medication management systems can assist aged care providers to overcome these issues by streamlining medication administration-related processes.
With mobile technology solutions, staff can now use mobile devices to sign in electronically at the start of a medication round. Only the medications to be administered during a specific round are displayed to the staff member, accompanied by photo identification of each resident along with useful directions to ensure medications are administered as intended. Staff can also input and retrieve important information about each resident at the point of care, which is logged and maintained in a clear and accurate audit trail.
The risk of timing errors are also reduced with electronic medication management, as alerts and alarms will automatically prompt staff if a medication has not been administered. For accountability, an adequate reason is captured within the system before progressing to the next resident. Electronic medication administration processes ensure all administered and non-administered medications are recorded, and can be tracked and reviewed at any time.
David Cox, former Managing Director of Embleton Care recognised the need to introduce an electronic medication management system to assist in providing safer, more effective person-centred care.
“Non-signing medication errors fell from 205 to 1 in the first month of implementation and have remained low in the months since the introduction of electronic medication management. Medications can no longer be missed as staff are prompted to provide a reason as to why a particular medication was not administered,” David said.
David also said that medication rounds at Embleton Care were much faster and easier since switching to electronic medication management.
“In comparison to our previous paper based system, our medication rounds are now 40 percent faster,” he said.
Communication with pharmacies
Another commonly recognised cause for medication errors is poor communication about medication between the pharmacy and aged care facility. Given the power of modern technology to help us all connect and communicate, technology will also be a key enabler in reducing medication-related errors and improving the safety and effective delivery of care.
Using a manual medication management system, the medication chart must be faxed or scanned to the pharmacy from the facility each time a change is made to a paper-based medication chart. In most cases, this requires a follow up phone call to confirm the pharmacy has received the chart and is actioning the changes. In less words, a very time-consuming and arduous process.
Electronic medication management systems provide greater security, management and accountability by facilitating online communication with the pharmacy. A clear and transparent flow of communications between the aged care facility and the pharmacy relating to residents’ medication requirements are recorded electronically to help eliminate the uncertainties around medication dispensing, and achieve optimal medication management.
Integration of clinical and medication information
Another key element in ensuring that the medication requirements of residents in aged care facilities are met will be through the sharing of these complete resident records between the GP, hospital, pharmacy and aged care facility.
In 2008, the Australian Institute of Health and Welfare (AIHW) released a report addressing the movement of patients between aged care facilities hospitals. The report revealed that of the 39,466 people admitted to hospital from facilities, 30 percent were admitted as a result of adverse medication events, of which up to 75 percent were potentially preventable.
During a period of transition, such as when a resident first enters an aged care facility or returns to the facility after a period in hospital, it is vital that clinical, care and medication information follows the resident and is available electronically to the right people who need it at the right time.
A medication management system that integrates care, clinical and medication information to create a complete electronic health record for residents, will go the extra distance in helping aged care facilities safeguard against compliance risks. An electronic health record ensures the sharing of up-to-date information between the GP, hospital, pharmacy and aged care facility, to improve both medication management and care outcomes for residents.
So there you have it – there are many ways that electronic medication management systems can reduce the scope for errors and improve resident safety, and we expect advancements in this area to be the greatest driver of declining adverse drug events in aged care.
Continue the conversation below. Let us know more of the ways electronic medication management systems are improving the safety of residents in your facility.
(Image credit: Naypong)