Improving the management of medicines within care homes is a national safety and quality priority. The evidence is everywhere, where does electronic medication management fit into it all?

You would be hard-pressed to find an article or program in the media about the care home sector that didn’t also emphasise the need for improvements. Particularly around the issue of managing residents’ medication.

It was reported previously that a care home in Torrs Park, Ilfracombe had received a formal warning from the Care Quality Commission (CQC), after failing to meet five national standards.

According to the report by the CQC, an unannounced inspection discovered people were not receiving the medication they needed at the correct times. One person had been “without six of their eight prescribed medication for eight days.” The report also said inspectors had “identified concerns relating to the management, obtaining, administration and recording of their medication.”

Concerns were also raised over the management of residents’ medication in a care home in Accrington. Inspectors reviewed the medication records for 15 different residents and found issues with all of them.

The CQC found three residents had gone up to seven days without some of their prescribed pills, which had put their health at risk. Four people had missed medicine doses because staff had wrongly recorded there was no stock in the home. Staff had also signed for medicines which were not given, and failed to sign for others which were given.

In the Headlines

And the statistics back up the news headlines. The reputable Care Home Use of Medicines Study (CHUMS) clearly concluded, there is an unacceptable prevalence of medication errors in care homes. Out of the 256 residents in 55 homes studied, 69.5 percent of residents had experienced at least one error. There is a recent blog post about the on-going UK Medication error crisis, if you are interested in finding out more.

In short, this situation can no longer continue. Beyond the obvious risk of non-compliance, medication-related errors have the potential to cause adverse drug events. As well as hospitalisation, and at worst, death of residents. The stark reality is, the majority of medication errors are preventable.

There are many ways that advances in information technology are helping to support pharmacists to prescribe accurately. To also allow Care and nursing staff to administer correctly, and ensure each resident takes their medication safely. Below are just some of the advantages that come with using an electronic medication management system.

Medication charts

According to CHUMS, medication administration errors made up almost a quarter of preventable errors that were occurring within care home settings. This is not at all surprising when you consider hand written, paper-based medication charts are widely recognised as the greatest sources of error when it comes to medication management.

Medication management systems that support electronic medication charts can significantly reduce errors associated with illegible handwriting. As well as unclear terminology, and other breakdowns in communication caused by paper-based systems. Electronic medication charts centralise all resident information in a clear and concise manner. This provides staff with more accurate and timely medication data at their fingertips. Electronic medication management systems greatly reduce the scope for medication errors and contribute to enhanced resident safety.

Integration of clinical and medication information

Improvements in the care of residents, particularly in the realm of medication management will result from ensuring care homes maintain highly accurate and complete resident records.

With paper-based systems, residents’ care, clinical and medication data is often fragmented. This forces staff to bundle together information from multiple sources and dual enter resident data. By the time this happens, the information may already be outdated. A flexible, electronic system that integrates care, clinical and medication data to create a more complete electronic record for each resident. This will go the extra distance in helping a care home organisation to safeguard against compliance risks. Staff will have instant access to important information for every resident. Which aids in improvements to both medication management and care outcomes.

Electronic medication management administration records

CHUMS also indicated that administration errors were suggested to be linked to the care home’s medication administration system. Distractions when administering medicines and lack of knowledge amongst some nurses/carers about how to administer medicines correctly.

Electronic medication administration records (eMAR) are assisting care home providers. They help to overcome each of these issues by streamlining medication administration-related activities. As an example, eMAR forces staff to login to the system and sign only once using a handheld device at the start of a medication round. Only the medications to be administered during a specific round are displayed on the mobile screen. Accompanied by photo identification of each resident along with useful directions to ensure ease of medication administration. Staff can also input and retrieve important information about each resident at the point of care. It is then logged electronically in a clear and accurate audit trail.

eMAR also assists in ensuring that medications are not missed. An alert prompts the user if a medication hasn’t been administered and a reason must be entered. This along with an electronic signature, in order to progress to the next resident. At this stage, all administered and non-administered medications are recorded, and can be tracked and reviewed at any time.

The extensive benefits of eMAR contribute to an immediate reduction in  signature omissions. It also reduces the time required by staff to complete medication rounds.

Enhanced communications with pharmacies

Communication between the pharmacy and care home by way of telephone or fax also often contributed to a number of medication errors, according to the CHUMS. Greater communication and collaboration between care professionals and pharmacists will play a critical role in reducing medication-related errors. This will improve the safety and effective delivery of care. Take a look at our iCareMeds Overview to see how this can be achieved.

Electronic medication management systems provide greater security, management and accountability by facilitating enhanced communication with pharmacies. A clear and transparent flow of online communications between the care home facility and the pharmacy relating to residents’ medication requirements are recorded electronically.

This effortless, two-way communication encourages pharmacists to contribute in monitoring and supporting care home residents. For instance, with the greater transparency, the pharmacy can also recognise the need for anticipating and avoiding ‘out of stock’ situations.

As pharmacies and care homes communicate and collaborate more with online communications tools, it will help both parties to achieve optimal medication management.

So there you have it. These are just a few of the ways that electronic medication management systems can reduce the scope for errors and improve resident safety. And we expect advancements in this area to be the greatest driver of declining adverse drug events in aged care.