Medication Management

By on Jan 22, 2019 in News

Every day, millions of Americans start their morning the same way: with a handful of prescription pills. In fact, nearly a third of all adults take five or more medications regularly. In senior living communities, the number is even higher with the average resident consuming a staggering 12-14 medications per day, thanks, in part, to a concept known as the prescribing cascade. This begins when a drug is prescribed, an adverse drug event (ADE) occurs, and the symptoms are misinterpreted as an entirely new medical condition, for which an additional medication is prescribed.

With advancements in science and technology, doctors and their patients now have thousands of different drugs to choose from. The influx of medications available on the market has caused prescription drug use to explode, growing 85% over the last two decades. This trend is exacerbated by a massive number of aging baby boomers, many of whom will soon require care. How can caregivers in the senior living industry manage medications and mitigate risk in an increasingly drug-dependent world?

One of the simplest strategies to implement is called the five rights:

The Right Drug

Prescription medications often have names that are easily mixed up. To minimize confusion between those that look or sound alike, the FDA reviews about 300 drug names a year before they hit the market—and about one-third of the names drug companies propose are rejected. For this reason, it’s critical to double or triple check the order with the label on the prescription packaging.

The Right Route

There are more than fifteen ways to administer medication, so never make assumptions. A pill, for instance, can be swallowed, crushed or held inside the cheek. Check that the medication can be given as ordered. If it’s an injection, check to see if it should be administered intravenously or intramuscularly. And if the medication lacks specific instructions, ask.

The Right Dose

Improper dosing is the number one contributing factor to fatal drug errors. When people age, there are changes in the way the body absorbs, distributes, metabolizes and excretes medications, and as such, extra care must be taken in determining drug doses for older adults, especially those in senior living facilities who take many medications each day.

The Right Time

Unless a prescription says take “as needed,” be sure to heed the timing instructions given by the pharmacist. Read the order carefully and check the medication administration record. Administering medications, especially antibiotics, haphazardly can significantly reduce their effectiveness.

The Right Patient

It sounds like a no-brainer, but with so much attention given to confirming medication specifics, the most basic thing to check can be overlooked: the patients themselves. Always confirm residents’ identity by looking at a wrist band or photo IDs. Ask residents to tell you their name and date of birth, and if they can’t tell you, find out if there’s a family member or physician on hand to verify their identification.

The five rights checklist above is commonly used by health care providers to ensure proper medication administration and reduce the risk of ADEs. While it’s regarded as a standard for safety, the five rights protocol is only a target for safe medication practices, not the definitive solution. In fact, many critics argue that the five rights are insufficient for mitigating risk because they do not take into account the significant contribution of human factors to errors. The good news is there are many new alternative solutions available, such electronic health records (EHRs) like Yardi EHR, which flag potentially dangerous drug interactions before they happen, alert staff if medications are missed and keep track of medications previously administered, among other things.

To learn more about how EHRs aid caregivers in medication management, download Yardi’s free white paper or read about Yardi EHR here.