Medication Errors in Nursing Homes

Some online estimates suggest that as many as several thousand patients in the United States have to deal with medication errors and their consequences every year. While it’s unclear as to what percentage of that population resides in assisted living facilities, it’s likely that a decent amount does. Medication errors in nursing homes are an issue for many reasons we’ll outline below, along with a listing of who makes these mistakes and ways they can be prevented.

Types of Prescription Drug Mistakes in Long-Term Care Facilities

The possibilities are, unfortunately, endless in terms of potential errors healthcare professionals or nursing home employees may make when interacting with residents at these facilities. Some of the common mistakes these caregivers or providers make include:

• Failing to take or read the resident’s full medical history before prescribing or administering a medication (to identify allergies, etc.)
• Not monitoring and reporting a ward’s adverse reactions to taking an over-the-counter or prescription drug
• Giving a resident the wrong medication
• Health care information technology (HIT) failures occur, resulting in the inaccurate recording of medication or patient data
• Administering the incorrect dosage of the correct drug to a ward (either too little or too much that it doesn’t have the intended impact)
• Providing the correct drug at the right dosage at incorrect times or intervals from what is prescribed
• Incorrectly storing the medication (i.e., keeping insulin refrigerated until the patient is ready to receive it)
• Providing expired drugs to a patient (that may not be as effective as they should be)

In terms of the first point above, a study published by the National Library of Medicine outlines how at least 50% of medication errors occur during the prescribing/ordering phase.

Who Is Responsible for Drug Errors?

While your initial inclination may be to assume that you or a family member’s direct caregiver at the nursing home is responsible for a drug error, and that certainly is who’s responsible in many cases, it’s not the only person who might be. Instead, the following parties may also be responsible for medication-related issues that occur involving residents:

• Doctors and nurse practitioners: It’s not uncommon for doctors or nurse practitioners to make house calls to long-term care facilities like these. Depending on the health care provider’s credentials, they may be in a position to diagnose or administer prescription drugs to a patient. Complications may arise because a doctor fails to take or review the resident’s medical history or to assess whether a prescribed medication will have an adverse reaction to a new one.
• Nurses: Traveling nurses may regularly stop by and check on their patients at these residential homes and administer medications when they do so. Much like the nursing home’s direct staff, nurses may give a nursing home resident the wrong drug or the incorrect dosage.
• Direct nursing home caregivers: These are employees directly hired by nursing homes assigned to monitor, administer medications to, and otherwise care for residents. Short-staffed facilities may make their employees feel overworked, leading their staff to “rush” in giving drugs to residents, leading to errors, or for them to forget to give them timely dosages.
• Pharmacists: The staff at the pharmacy that does the compounding or dispenses the drug is responsible for doing so just as the doctor ordered. If they fail to do so, a patient could receive the incorrect drug, too little or too much of one, etc.

It’s also not out of the question for fellow residents, friends and family members, support staff, outside vendors, and others with any access to nursing home residents to tamper with medications or administer an over-the-counter, prescribed, or illicit drug that can adversely impact their health and take their life.

Minimizing the Chances of Medication Errors in Nursing Homes

Residents who have their cognitive functioning intact and are vocal in advocating for themselves or who are regularly surrounded by supportive family members or friends are the ones least likely to fall victim to drug errors. Why? It comes down to them being a lot more proactive when it comes to doing all the things they tell you to do to avoid having something like this happen to them.

Steps to take to minimize the chances of a medication mistake happening on your watch include:

• Independently verifying information health care providers may tell you about medications, contraindications, etc., to make sure it aligns with what you find.
• Asking questions when unsure about whether you’re being administered the correct drug or dosage, your reaction to the drug is normal, etc.

While not every adverse reaction to a drug may be avoidable, instances like this may be a strong indicator of nursing home neglect. Being on top of your care can greatly minimize the chances of medication errors in nursing homes.