Ahem. JCAHO, if you are really serious about making medication reconciliation work here is what you need to do - pay attention now, here is something you could do that REALLY WOULD IMPROVE PATIENT CARE.
Create a national data bank that is immediately accessible by any health care provider that has all of a patients prescription information readily available. When a patient takes a prescription to a pharmacy it goes into the database, the pharmacist would also benefit by seeing what the patient is getting filled at other places, like the 120 Vicodin he filled across town yesterday. When a patient is given a sample his practitioner would have to hand enter the info into the data base.
Until something like this is created, medication reconciliation will never work. So many patients either a)Have no clue what they take or b)lie about what they are taking or c)get meds from many different doctors filled at many different pharmacies. We simply do not have infinite time to call around to all the pharmacies in town to try to figure out what they are actually on. I feel it is much more dangerous to send out an incomplete or inaccurate list than to not do one at all.
So JCAHO, here's your chance to walk the walk, show us that you really do mean to improve patient care.
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- ERnursey
- A hardworking ER nurse trying to survive until retirement and if I can have little fun or have a positive impact on someone's life, all the better!
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12 comments:
A-freakin-men.
I am printing this and posting it at work tonight.
Too many times I hear "oh, I take the green one twice a day, the blue one once a day, and that striped one? It's every other Thursday but only when the snow is white and fluffy... not that wet sticky stuff."
And they have NO CLUE what any of them are for. None.
I like the database idea. It would also be fantastic, like you poked at, for putting a flashing red light on drug seekers that pharmacy and doctor-hop to get what they want.
Whitecap nurse says: AMEN, amen, amen - What you said ER Nursey - amen!
absolutely, positively spot on ERN!!
Excellent, excellent idea, however, where would JCAHO get the money to create such a database?
One of the most infuriating things about healthcare IT is that we have the technology readily available to do such things, and yet no one wants to invest in this technology.
This has been a common theme this week. I think Madness in the ER complaining about "The Joint Commission" just the other day. They make such idiotic rules and regulations that are not even remotely possible to follow through with. Who serves on JCAHO? Obviously not practicing nurses! GRRR!!!!
I'm pretty sure Dr. Deborah Peel would oppose something as sensible as this.
What if someone found out what you are taking - the horror.
If someone were interested in what you take, then it would probably be a nurse in triage - not someone from the Weekly World News (RIP).
Imagine doing The Joint Chokers (TJC is their new acronym?) doing something to really protect patients from themselves.
Maybe just one "doing" works better. :-)
See what is happening in the UK. Central databases mean zero patient confidentiality www.thebigoptout.com
With regard to "the big opt out," if people don't want healthcare workers knowing what (in its entirity) is wrong with them, then why in the world are they coming to us for care? I'm sorry if your raging case of gonorhhea or erectile dysfunction is embarassing, but how about when you come in as a trauma and all we know about you is your name and SSN? I, for one, would at least like to know what on God's green earth you are taking/allergic to, so I don't give you something you shouldn't have. This just seems like a "duh" situation, and more like a handful of uber-privacy gurus flexing their muscles to put up yet another roadblock to effective patient care.
Latest Newspaper reports in the UK read that the government want 50 million patients on the database. In an emergency is A&E going to spend 20 minutes trying to find the right Sarah Jones. If they choose the wrong one but onewho has the same or similar date of birth etc who will liable if they receive say, for example, pencillin to which they are acutely allergic?
Also if patients start withholding information from their doctors, due to worries about confidentiality, once again who will be liable if something untoward happens.
What about the risk of a victim of domestic violence being found by her partner because her sister-in-law works in A&E? Who will accept liability for this?
I really do think that these databases which ever said of the worlds they are on is the medical profession taking control of patient healths and lives. It should be up to patient to disclose the amount of info they feel comfortable with to the medical profession not for the medical profession to access the info without informed consent. This to me amounts to abuse of power by the medical profession.
As a traveler RN I have seen several hospitals response to JCAHO's call for med reconciliation. All I see happening is the admitting physician uses the info to write admit orders (it saves him/her time). What a load of BULL! If not a national database, at least a really heavy media blitzing push to "KNOW YOUR FREAKIN' MEDS, PEOPLE"! How about replacing every erectile dysfunction and sanitary product commercial with PSA's designed to scare the crap out of patients who DON'T know what they're taking and why! As an ER nurse I'm sure that someday I will throttle the patient who tells me, "It's in my record, look it up"
antebeth,
If you get any nurses on the jury, they will not convict you. Throttle away. :-)
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