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Medication Errors Could Diminish With Increased Communication

Two recent studies point to the importance of communication between patients, doctors, nurses and pharmacists. While it seems like a simple concept, the execution is somewhat more difficult.

In one study, Doctor Jeffrey L. Schnipper's team randomly assigned 322 patients from two hospitals to have their medications entered into a computer program at admission that was designed to reconcile those medications with the ones they were taking when they left the hospital.

In addition, the researchers tried having doctors, nurses and pharmacists take the patient's medication history and keep track of all the medications they were taking.

His study resulted in a 28 percent reduction in medication errors; only 43 patients in his group suffered errors, compared to 55 outside his study.

As Schnipper noted "Patients don't know what they are taking. You have got to carry your current accurate medication list in your wallet," he advised. Because of this, hospitals cannot rely on patients to provide accurate information.

The system has continued to improve, with medication errors being reduced to half an error per patient, as the hospital and staff become more acquainted with the new system.

"Standardizing the process of who is going to do what in regard to medication reconciliation in hospital admission and discharge is really the biggest challenge organizations have," Matthew Grissinger, a medication safety analyst at the Institute for Safe Medication Practices.

Because mistakes made at admission cascade through every care decision made for a patient, it is important that this process be standardized and replicable.

It has to be done right every time and it has to be capable of having different people input information at different points without building errors into the system.

A second study points out the benefits of having a pharmacists involved with medication decisions, working with doctors and nurses. In this study, pharmacists were assigned to monitor patient's drugs and communicate with the patients and their doctors about the medication regimen.

This involvement resulted in a 35 percent lower risk of an adverse drug reaction and a 37 percent lower risk of medication error.

Dr. Michael D. Murray, chair of the department of pharmaceutical policy and evaluative sciences at the University of North Carolina at Chapel Hill, noted, "By working closely with doctors and nurses, pharmacists can help people avoid problems with their medication for chronic diseases like high blood pressure and heart failure. This has favorable effects on health and health-care costs."

While this may seem obvious, the hectic environment of hospitals and the dozens of people involved with the care of each patient create many places where a system designed to protect the lives and health of patients can break down.

Having standardized processes robust enough to survive this environment can help, as well as obtaining input from professional like pharmacists, who should best understand the potential for dangerous drug interaction and types of drugs prone to prescription error.

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