The typical process of medication management within a care home setting is complex and requires many essential steps, various information sources and the involvement of internal and external healthcare professionals.

Strengthening these interdisciplinary partnerships and streamlining the workflows that support medication administration will play a critical role in protecting elderly residents from the adverse events caused by medication errors.

According to the Care Homes Use of Medicines (CHUM) study, errors occur on 8.4 percent of medication administration events. That would mean that a care home resident being administered medication three times a day, would have an 84 percent chance of receiving a medication administration error every week and a 99.9 percent chance every month.

To give credit where credit is due, there are signs that medication standards in care home homes have improved dramatically in the last decade. The Care Quality Commission has reported that the proportion of care homes meeting or exceeding that national minimum standard on medication had jumped to 70 percent by 2009. But there is still room for improvement, with a significant amount of care home medication errors being preventable.

Preventable medication errors and discrepancies are caused by a combination of factors. Firstly, the use of multiple medicines by residents is common in care homes, given their complex care needs. In the Centre for Policy on Ageing’s Managing and Administering Medication in Care Homes for Older People, it is suggested that care home residents are, on average, prescribed seven to eight medications. Using this statistic, it is reasonable to assume that a 100 bed care home would be administering about 700 to 800 medications to residents per day.

Now consider that the primary tools being used by the majority of care home providers to manage their residents’ medications still largely revolve around paper-based systems with significant limitations. It becomes very challenging to provide the highest levels of safe and quality care, while using a manual approach to administer such large volumes of medications.

The new era of electronic medication management

An upward trend has occurred over the past few years, where we are witnessing a greater number of care home providers taking the necessary steps to improve medication management processes. By restructuring and investing in electronic medication management (EMM) systems, many providers are achieving an immediate and substantial reduction in preventable medication errors.

Apart from the obvious need to reduce the risk of harm to residents, implementing EMM systems within care homes can result in organisation-wide efficiencies. Below we have outlined five ways that your organisation and its employees can enhance medication administration outcomes with the implementation of EMM.

1. Reduced compliance risks

In a typical care homes setting, drugs are administered by trained care staff at appropriate intervals throughout the day. There are usually three to four medication rounds per day, which are demanding, time-consuming and often laden with interruptions. In fact, the CHUM study described interruption during medication rounds as ‘frequent’ or ‘constant’ and identified interruptions as the most significant contributor to medication errors. Not surprisingly, they can also lead to serious compliance risks.

EMM systems outperform paper-based systems in this regard, with intuitive alerts and warnings that automatically prompt staff to comply with the highest standard of medication administration procedures. These embedded safety alerts and warnings further support accreditation requirements by enforcing the six Rs of correct medication administration – right resident, right medication, right route, right dose, right documentation and right time – and confirming that the welfare and rights of the resident receiving the medications remain the priority throughout.

EMM also enables care home providers to safeguard against the compliance risks associated with the administration of PRN ‘as required’ medications. EMM systems ensures staff coordinate, administer and track PRNs with greater efficiency, by capturing a detailed history for each resident, as well as documenting the reason why the PRN was administered. EMM systems that integrate with electronic clinical systems also allow this information to be automatically updated and recorded within daily notes, eliminating the need to rely on human memory. This ensures overall greater accuracy and more effective evaluation of PRN medications.

In a revenue-constrained environment, care home operators must ensure compliance. Due to the way funding works in the UK, non-compliance also negatively impacts directly on funding and hence the organisation’s bottom line. By safeguarding your organisation’s medication management processes with a robust electronic system, you’ll achieve a greater compliance rating and more funding as a result.

2. Increased efficiency and productivity

Paper-based systems force staff to spend valuable time searching through paper-based records when determining what medications are due throughout any given medication round. This process is not only lengthy, but can easily increase the opportunity for discrepancies and errors.

An EMM system offers a tangible boost to efficiency and productivity by saving staff from manually sorting through paper-based medication records to determine what medication is due at what time. EMM systems support centralised, electronic medication administration records (eMAR) allowing staff to only view the medications that are due to be administered within a given time period. To further support efficient medication administration, important information about each residents’ preferences can be accessed at the point of care, accompanied by photo identification.

3. Reduced pressure on resources

Responsibilities of care homes in the medication management process incorporate checking in, administering, ordering, reordering and disposal of medications. Registered and enrolled nurses in care homes are therefore responsible for the daily managements of hundreds, if not thousands, of medications for residents.

EMM reduces the pressure of these tasks by providing a centralised electronic record that can be accessed by all authorised staff working within the care home. The greater control and transparency provided by EMM systems enable organisations to leverage staffing skills and resources more effectively, and more widely distribute the workflows relating to the management of medications to endorsed care workers and assistant.

4. Enhanced governance and decision making

In addition to improving workflows, EMM systems also alert staff to potential safety issues or any missed steps relating to the administration of medication. This helps social care providers to ensure that their organisation’s medication administration processes and records are carried out to the highest standard.

With functionality to electronically capture data and centralise information in one system, EMM also increases visibility of medication management processes throughout multiple care homes. EMM enables management to obtain access to data in real-time including medications administered, medications missed, PRNs and more. This data can be accessed at any location within the organisation, without the need to rely on transporting paper-based records. This electronic data can also be analysed to improve decision making affecting operations, staff and resident health outcomes.

5. Streamlined communications between care home and pharmacy

Although the features of EMM systems significantly improve the actual process of administration, the improvements to the medication ordering process are also important. Especially when you consider the CHUM study also found that half of all communication-related medication errors occurred between the care home and the pharmacy.

EMM systems streamline the documentation requirements of medication management by facilitating electronic communication with the pharmacy. A clear and transparent flow of communications between the care home and the pharmacy are recorded electronically and can be tracked to help eliminate the uncertainties around medication dispensing, and achieve optimal medication management. EMM is already proving to be a key enabler in reducing communication-related medication errors and improving the safety and effective delivery of care.

6. Improved daily experiences for care and nursing staff

The entire social care sector faces challenges with recruiting and retaining qualified staff. These challenges are compounding due to an overall shrinking workforce and increasing workloads for those who remain in the industry.

Taking advantage of EMM systems can support the demands on care home staff and improve the overall care experience for all involved. EMM systems free staff from the intensive documentation and administrative duties that paper-based systems necessitate, providing more time to focus on providing safe and high quality care to residents. In our own experiences, EMM systems are quickly embraced by staff in care homes because they are easy to use and do not add to existing workloads. Instead, they are designed to complement the processes and information associated with existing clinical systems.

In addition to improving safety for residents, implementing electronic systems to provide critical clinical and medication information at the point of care will go the distance in reducing system-wide inefficiencies, compliance risks and the pressure on care home staff.  If you’d like to find out more about electronic medication management systems for aged care, visit this page.