Using Patient’s Own
Home Medications
As patients spend longer times in the emergency department waiting
for beds, many times we resume either all or some of the patients home medications. We have had several errors within the past
few weeks in which drugs were resumed which should have been held or the
medications the patient had were not appropriately filled with what the bottle
stated. Here we will review the hospital
policy on using patients own medications.
Medications brought into the hospital by the patient are normally
sent home with the patient’s family or guardian. These medications are not
administered unless they have been identified by a pharmacist and there is an
order from a physician to administer the medications. If the patients own medications cannot be
sent home with a member of the patient’s family or guardian, then the
medications are labeled with patient’s name, locked in a cabinet in the
medication area, and returned to patient at time of discharge.
If a physician writes an order to administer medications brought
from home, then the physician must identify the medication to be taken from
home by name and write specified directions for use. The order “patient may take own meds” is not sufficient
and will not be honored as a valid medication order. Once obtained from the patient, the
medications must be verified by a pharmacist. Medications identified will be
labeled with the date and initials of the pharmacist doing the identification.
If the physician writes “may take home meds”, the nurse may write
out the list of medications. Then the orders must be verified by the physician
and the bottles verified by a pharmacist.
Oseltamavir (Tamiflu®) – not as safe as originally
thought??
Roche
Laboratories Inc. recently revised the safety labeling associated with its
product Tamiflu® (oseltamavir), and given that the flu season is in
full effect, it is important to highlight this safety information. Oseltamavir is indicated for the treatment of
uncomplicated acute illness due to influenza infection in patients one year and
older who have been symptomatic for no more than 2 days. Oseltamavir is indicated for the prophylaxis
of influenza in patients one year and older.
There have been post-marketing reports (mostly from
CMC Drug
Error Report …
Some examples of errors or near
misses that have been reported by you:
v
Order
to resume patient’s home meds which included warfarin. Pt had an INR of 5.
v
Patient
was to take own home meds from the patients supply. One bottle was misfilled and did not contain
the drug the bottle was labeled with.
v
Patient
with a creatinine of 2.4 received IV contrast in CT even though IV contrast was
crossed off on the form
v
Patient
in DKA had insulin drip at same rate and not adjusted when should have been.
v
One RN received a verbal order for Dilaudid, and
another RN had the green sheet order.
Both nurses almost gave Dilaudid.
Please continue to report any error(s) you
encounter or make, or any near miss.
Remember this is completely anonymous.
1/2 Molly Durkin,
Deborah Shepherd
1/5 Ora Rempson
1/9 Carleen Kaucky
1/10 Kate Paquette
1/11 Barbara McCreary,
Frieda Roessner
1/12 Kathy Penman
1/13 Jessica
Hugl-Wajek
1/14 Dennis Ryan
1/19 Steve Nanini,
Adam Tuite
1/23 Collen Fiedler,
Janet Hopp
1/26 Chris Kerwin
1/28 Claudia Santin
1/31 Ken Kelley,
Chintan Mistry
Dr. Robert Harwood recognized as “Program Director of the Year” by AAEM
GO BEARS
!!!!!
Please forward any news or announcements via email or
IBEX to Rolla Sweis.
Any questions or comments please
send to:
Andrea Carlson, MD
acarlsonmd@comcast.net
rogu@alum.mit.edu
Rolla Sweis, PharmD
Rolla.Sweis@advocatehealth.com