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We asked Carl Grove, Director of Pharmacy at the Parkview Adventist Medical Center, to tell us more about preventing medicine mistakes when we are in the hospital.
When we go into the hospital, what can we do to help make sure we get safe care?Carl Grove explains: Ask questions! Ask: What's going on? What am I getting (for medicines)? What are you doing? Knowledge is power. Learn. And if you feel awful and you're in pain and all that, ask a family member to ask for you. Many mistakes in hospitals are medicine mistakes. Ask questions about medicines. Ask:
Why is the pharmacist so important in a hospital full of doctors and nurses?Carl Grove explains: A pharmacist has the knowledge and skill to spot trouble with prescribed medicines. Working with a good computer system, a pharmacist can greatly reduce mistakes. So, you get only medicines that:
A patient in the hospital for routine surgery will get around 20 to 30 different medicines. We need experts using good systems to keep track of them all. If we have capable pharmacists and good computer systems, how do so many medicine mistakes happen?Carl Grove explains: A computer can be a good back-up for double checking medicines. But computer systems only help when they are used and used right. And they can be hard to use right. If the pharmacist has gone home, the doctor or nurse may not have been trained to use the computer, so the system may not be used at all. In most hospitals, medicine-check computer systems are located in a central pharmacy and are not even available on the nursing units. And, with all due respect to our doctors and nurses, they don't have the same education as pharmacists to spot trouble with medicines or the same level of skill in using medicine-check computer systems. |
In addition, many medicines used in hospitals are "floor stock," meaning they are kept in cabinets on the nursing units, and are not ordered from the pharmacy. For example, anesthesia is given this way. Medicines in the emergency room are also given this way. When a patient gets floor stock medicine, it may not get checked by the pharmacy computer, even if the pharmacist IS on duty. So, if we have a bad reaction to a medicine, should we assume it wasn't double checked by the pharmacist or computer?Carl Grove explains: Not necessarily. It's always good to ask whether your medicines have been double checked. But sometimes a reaction can just happen without any warning. It's the pharmacist's job to help make sure you're given the right medicine in the right dose and at the right time that it will mix fine with other medicines you take, and that you're not allergic. We can't know in advance whether a certain medicine will cause a side effect for you. What are hospitals required to do to make sure medicines are double checked by a pharmacist and/or computer?Carl Grove explains: Very little. No government agency regulates hospitals. And hospitals don't have the same systems as grocery stores or Fed Ex. These businesses use state of the art computer systems to track every product or package. The check out clerk or , FedEx driver uses a computer to scan a bar code marked on the item. Grocery stores track all the products on their shelves using bar coded computer systems. And if you pay with a credit card, they can track just what you bought. Likewise, Fed Ex tracks your package from the time you send it to the time it's delivered. You can always find out where it is because it was bar coded when you paid for delivery. Right now there aren't bar codes on all medicines and hospitals don't have the computer systems to track all medicines. If they did, we could track them that way, wherever they were used in the hospital(even scanning them in at the bedside. And if a dose was forgotten, a beeper could sound to remind the nurses. Every medicine for every patient could be recorded and double checked. When these systems are in place, medications will be a lot safer. So, what's a patient to do?Carl Grove explains: Patients can ask their local hospital about any of these issues, such as the days and hours a pharmacist is on duty, whether a computer system is used to double check all medicines before first dose, or what other systems are in place to reduce medicine mistakes. Hospitals vary quite a lot in some of these areas. When a doctor prescribes a new medicine for you inside or outside the hospital, be sure to ask and know the answers to these questions:
Patients are now part of the health care team and they need to play an active role in their own care whenever possible, even in the hospital. Working together, patients and staff can reduce medicine mistakes and improve the safety and quality of care. |