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Every day in this country someone dies from a medication mistake. According to the FDA, more than one million people are injured annually because of drug errors.
In some cases a patient gets the wrong medicine from the pharmacy. Other times it is the wrong dose. In the hospital, a patient may be given an intravenous solution (abbreviated IV) instead of a medicine dose in international units (abbreviated IU).
There are many reasons for such errors. People may mis-read or mis-hear drug names. For example, the anti-seizure drug Lamictal could be easily confused with the antifungal medicine Lamisil. Over the phone the anti-anxiety agent Xanax sounds a lot like the acid suppressor Zantac.
That is why physicians, pharmacists and nurses should pay attention to airline pilots and air traffic controllers. They have developed checklists and techniques for reducing misunderstandings.
To avoid confusion with letters that might sound alike such as F and S, pilots use the words Foxtrot for F and Sierra for S. B and V are easy to mix up, so pilots use the words Bravo and Victor.
Perhaps it is time for health care to borrow a page or two from aviation. Setting up systems to catch errors before they harm patients is a good idea.
Drug safety experts have come up with a recommendation to emphasize the differences between drug names. They suggest using "tall man letters" to make the distinctions stand out. This means capitalizing the most distinct parts of a similar pair. This would cover drugs such as buPROPion (an antidepressant) and busPIRone (an anti-anxiety drug), or the heartburn medicine PriLOSEC and the antidepressant PROzac.
Many hospitals are turning to barcodes to make sure that the drug the doctor orders is given to the correct patient. Both the medicine container and the patient have barcodes. The patient wears the barcode on a plastic ID bracelet.
Nobody has a higher stake in avoiding medication errors than the patient, so it is time patients became part of the health care team. Along with doctors, nurses and dietitians, patients should be double-checking everything they are given in the hospital.
If they are not familiar with a drug the nurse brings, they should ask who ordered it and why. If a person on a low-sodium diet is served three slices of bacon with breakfast, that doesn't mean it is okay to ignore the diet and enjoy the salty bacon. When patients are too sick to pay attention and stand up for themselves, a family member or friend should be advocating for them.
Outside the hospital there are other measures that can help against medication mishaps.
* Do not request that your doctor phone or fax in a prescription. The time you think you may save is not worth the risk.
* Always get a photocopy of your prescription so you can double-check your pill bottle with the original prescription.
* Make sure you can read the prescription. It should be typed or printed in English. No Latin abbreviations or scribbles should be accepted.
With medication mistakes so common and so dangerous, it is crucial for patients and their families to be vigilant. Health care professionals should welcome patients as a vital part of the health care team.
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I totally agree that patients should double check what they are given in the hospital. I was in the hospital for a month in 2002. During that time, nurses tried giving me the wrong medicine at least once a week. Three times it was a drug that I had already had that day and the fourth time it was a heart pill. I was not on heart pills. I caught the errors and did not take any of the drugs. I was very lucky because even though I was very ill I still had the mental capacity to recognize what was going on.
Really ill people should have a family member in the room at all times to watch out for such mistakes. It's really unbelievable what goes on in hospitals. I even had doctors who couldn't read an xray. They keep saying my lungs were clear. I had to call in a pulmonologist to find out what was wrong because I couldn't breath very well. I had double pneumonia and almost died because of the first doctors' idiocy. I was very happy to get out of the hospital alive.
A fax might not be so bad. A typed prescription is good. A prescription written by the nurse, but signed by the doctor is more legible.
1) Patients should demand discharge counseling on their medications when leaving the hospital and counseling when at the pharmacy.
2)Patients should demand that their medication labels are easy to read.
This link describes what a prescription labels should look like: http://www.ismp.org/Tools/guidelines/labelFormats/comments/default.asp
When your pharmacist or other person says they cannot make these changes to ensure YOUR SAFETY they are sadly telling the truth. Keep going up the chain until you get results. UNLESS money is involved we will not be heard.
I was admitted to a hospital for 24-hour observation after suffering chest pressure and tingling in my left arm. Although I was on high blood pressure medication already, I was given nitroglycerine patches as a preventive measure, so I was interested in watching my blood pressure drop into the 110 over 60 range. I was in a ward that had only curtains between beds, so I overheard that the man next to me had appendicitis and would have his operation first thing in the morning.
In the middle of the night, the nurse came into my space and said that I needed to take something to reduce my blood pressure because I was "cooking" at about 200 over 100 or something like that. I refused the medication because I knew what my blood pressure should have been and told her that she had the wrong patient. She went back to the desk and found out that she had been looking at the wrong bed's remote blood pressure monitor. She didn't say, but I figured it must have been the monitor for the man next to me; it certainly wasn't mine.
Needless to say, if I had taken that medication, I would have "crashed" as my doctor later put it and I might not have made it through what fortunately turned out to be a false alarm.