Opening the box on medication
The starting point to ensuring a safe, efficacious medication management regimen is having an accurate medication profile when an elderly person enters residential care by Gerard Stevens AM
PAGE 20
Minimising medication distress in transition to aged care Medication management in residential aged care has been under the spotlight of the Aged Care Royal Commission and, in many instances, has been found wanting. Headline-creating concerns have centred on the use of psychotropics and sedatives as ‘chemical restraints’ but there is also strong evidence of a high level of variability in the practices surrounding safe and efficacious medication management. It therefore requires robust clinical governance and an increasingly strategic collaborative approach in its delivery. Residents are entering aged care much older and frailer, often with complex care needs and requiring multiple medications. With Government policies and new guidelines driving the change to consumer-centred care, it is essential that aged care staff are supported by safe, appropriate, effective and efficient medication management systems.
The starting point to ensuring a safe, efficacious medication management regimen is having an accurate medication profile when an elderly person enters residential care. Some facts We know that up to two-thirds of medication histories have errors and a third of these errors can cause harm.1 Sources of error in aged care homes have commonly been identified:1 •
on admission;
•
when recording information to the medication chart;
•
during transfer between wards/sections/ hospitalisation;
•
when doctors change; as a consequence of poor communication; and
•
missing information.
We also know that two-thirds of residents are admitted to a RACF via their home and one-third come via hospital.2 Yet, on average, 80% of discharge summaries contain a discrepancy and 15% of medicines intended for continuation were omitted on discharge prescriptions.3
