Nursing Home Medication Errors Linked to Delivery Format

Nursing home staff are more than four times as likely to give incorrect doses when a medication is in liquid form, according to a recent study published in BMJ Quality and Safety. The study evaluated medication errors in 55 care homes in the United Kingdom, caring for 233 residents in total.  Assisted living staff may make errors dispensing medications

In most cases, medications are provided in the form of pills or capsules, which can be easily used with a monitored dosing system (MDS). A MDS contains a compartment for each day or each time of day when medication is to be given; the compartments contain the appropriate number of pills or capsules for each dosage. Medications given in liquid form, however, cannot be used with a MDS.

Many residents in nursing home facilities require medication delivery in the form of liquid, creams or lotions. Swallowing difficulties make it dangerous to give pills to some residents, while other medications are simply more effective when given in a liquid or cream form.

More than half of medications given in the study were delivered with the use of a MDS (53%) and were not free of error, although errors were more than four times as likely to occur with liquid medications than with pills or capsules. Mistakes were 19 times as likely for medications administered in cream, lotion or eyedrop form, and more than 33 times as likely with inhaled medications.

It’s not just pills versus liquids that makes the difference, either. Pills and capsules stored and dispensed from the manufacturer’s original packaging were twice as likely to be given in incorrect dosages than pills and capsules dispensed from a monitored delivery system.

Elderly nursing home and assisted living residents are at higher risk for complications from medication errors due to differences in the way their bodies metabolize drugs and the increased frequency at which many are required to take medications. Monitored delivery systems eliminate a large percentage of errors, but they’re both costly and difficult to maintain, particularly when multiple doses of several medications must be administered throughout the course of a single day.

While the authors don’t offer a one-size-fits-all solution, they do point out that additional staff training on appropriate medication administration can reduce the number of errors for medications that can’t be dispensed through a MDS, and the use of a MDS drastically reduces errors for compatible medications.

Read more on this study at Science Daily.

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