Monday, December 25, 2006

Hospital Discharge Medication Error | Blog's Mission

In addition to the original mission, this blog will now serve as a companion blog of my website,

The original mission is to tell real medical stories and inform visitors about medical errors and medical errors reduction strategies. This mission still stands.

One frequent medical or medication error at the time of a patient's discharge from a hospital's The Discharge Instructions about Medications.

Most patients before being admitted to a hospital are on several medications and most of them neglect to take the list or the actual medications to the hospital.

During the hospital stay, a patient's medications can be changed substantially.

At the time of discharge, most physicians in the past will write "continue all meds at home", although now most hospital rule will not allow this type of discharge order but it still happens due to certain hard-headedness, and "I am the boss" mentality of some physicians.

Recently a patient of mine, under the care of a a specialist in the hospital, was discharged home with very poor medications instructions. Please notice the instructions is in pleural.Actually there were 2 sets of instructions, one written with the list of medications taken during the hospital stay to be continued at home, and a verbal instruction from the nurse to to continue all the meds at home.

To make matters worse, the patient has Alzheimer's and the caregiver did not question the instructions. Also the caregiver did not call me immediately after discharge. This medications error was found out 7-10 days later at a follow-up visit in my office. By that time the patient was even more confused and could hardly stand up due to overdosage of a few medications. Luckily the patient survived.

The Discharge Medication Sheet must be the one and only instruction. It must list all the medications to be taken, including over the counter ones. The patient must also be informed to continue any medication that the patient was taking before admission.

The communications between the patient, the admitting physician, the nurse and the primary carep hysician, if he or she is not the admitting physician is very crucial to prevent this kind of mistake.

One more very effective measure: The patient or caregiver inform the primary care physician about the discharge medications immediately after discharge and ask which medications to take, to prevent duplication or discard of expensive medications the patient was taking before admission.

The primary care physician must respond to this request professionally and as soon as possible to prevent waste of medications and harm to patient. This is the safeguard to prevent medical errors committed by human almost daily in any hospital.