Prevent dangerous medication mistakes

Hold medication inservices for aides

Managers at Olsten Kimberly Quality Care in East Lansing, MI, were reviewing care plans and aide instruction sheets when they discovered some problems with medication policies.

The policies had nonspecific instructions that could cause aides to make mistakes.

"Our concern is about what would happen if they were to pick out the wrong bottle and give them the wrong medication; it’s the liability. So we want to be very careful," says Lesleigh Smith-Farhat, RN, recruitment staff development manager for Olsten Kimberly, a full-service agency that serves five counties in central Michigan, including the state’s capital.

Fortunately, there had been no problems, but the agency wanted to make sure there wouldn’t be any mistakes with patients’ medications. So Smith-Farhat held a medications inservice for aides and nurses.

Olsten Kimberly Branch Manager Mary Johnson says the inservice was well-received by the staff. "It was a good reminder because they always need to be reminded what to do. Sometimes we get lax," she says.

Smith-Farhat says she started the inservice by discussing general information about medications. "Then I talked about how medications are used for certain diseases."

Her inservice covered the following areas:

• medication vocabulary (see medicine vocabulary, p. 7);

• medicine packaging and reading prescription labels;

• prescription drugs and over-the-counter drugs (see medications chart, pp. 8-9);

• the agency’s medication rules;

• safe storage of medicine. (See story about proper medication storage, below.)

"We also review this information whenever we hire new staff," Smith-Farhat says. "Many aides will say that at this group home they were allowed to give an injection or give out medication, and maybe they feel that because they did it before, they should be allowed to do it again."

But Olsten Kimberly’s policy prohibits aides from giving out medication.

"The aides’ role is to remind and assist," Smith-Farhat says. "Their role is to assist at the client’s direction, and the client has to be self-sufficient."

Instead, she adds, it’s better if the patient has the medications already placed in a pill box with labels.

Another pointer Smith-Farhat gives aides is about what to do with a patient who complains of frequent urination during the night, and the patient is taking water pills.

"The aides need to address this with the nurse, and maybe the patient needs to take the pill early in the day, so he won’t lose sleep over going to the bathroom repeatedly," she explains.