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Medication Errors

Most nursing home residents are in a stage of life in which proper dosage of medication is very important for maintaining health and quality of life. Unfortunately, nursing homes sometimes make medication errors that can cause serious injuries and even death. Medication error-related injuries in nursing homes are common and often preventable. The more medications a patient is taking, the greater the chance of interactions, and the greater the risk of errors. Many nursing homes cannot afford the expensive computerized medication dispensing and monitoring systems that hospitals are purchasing, and few nursing homes have found ways to minimize the problems resulting from having many different doctors treating patients. Both of these factors lead to nursing home medication error occurrences.

Studies have shown that psychoactive drugs (antipsychotics, antidepressants, sedatives and hypnotics) and anticoagulants were the most common medications associated with preventable adverse drug reactions in nursing homes. Adverse drug reactions include oversedation, confusion, hallucinations, delirium, falls, and bleeding. Nursing home medication error risks can be considerable because many patients are on a number of prescriptions and already have compromised physical health conditions. Nursing home and medication error risks are also exacerbated by the fact that nursing homes are often understaffed, increasing the likelihood of mistakes in dosage and frequency of medication administration.

Nursing home medication errors may involve a number of different circumstances, including:

• Lack of proper patient assessment
• Lack of monitoring for medication's efficacy
• Lack of reassessment for continuous need for medication
• Lack of monitoring for adverse drug reactions (ADRs)
• Lack of recognition of ADRs
• Attributing symptoms of ADRs to other causes
• Inadequacies in nursing home staff education or training
• Nursing home employees stealing medication and substituting another in its place (for example, substituting Aspirin for Oxycontin)
• Administering medications late
• Missing a medication and giving double dosage at a later time
• Administering the wrong medication