Medication safety is a top priority at UMMC. The practices and programs we are using to reduce medication and treatment errors are described below.
Computerized Prescriber Medication Order Entry (CPMOE)
Prescribers enter medication orders electronically into our computer system. The prescriptions are typed, so they are easy to read. Pharmacists review the medication orders on the computer within minutes, and the computer system alerts both prescribers and pharmacists if there are important drug interactions, any orders for the same medication, any patient allergies or reactions to the medication, or if a dose is too high.
Robotic Medication Dispensing
The Pharmacy Department uses a "Robot" to dispense a majority of patient medications. The robot receives the medication order from the computer system. The robot uses barcode scanning to find the correct medication and dispenses this medication to the patient. The robot is 100% accurate in the selection of the medications.
Electronic Medication Administration Record (EMAR)
The same computer system that is used for ordering medications is used by nurses for medication administration. Nurses are prompted to give patients their medications at the right time. The computer shows the nurse when the medication should be given after the prescriber orders it. Nurses are also prompted to document the location of injections and the location of a medication patch that is placed on a patient. They are prompted to document removal the previous medication patch before a new one is placed. The EMAR also prompts nurses to ask patients about pain after a pain medication is given.
"Smart" Intravenous Infusion Pumps
Many patients receive medications through an IV or intravenously while they are in the hospital. At UMMC, patients' intravenous infusions are programmed into an infusion pump with technology that checks the pump settings to make sure that the patient is receiving the correct dosage of medication. The pump alerts the nurse if the dosage is over the recommended range for that medication.
Unit Based Cabinets for Medication Storage and Dispensing
A Unit Based Cabinet (UBC) is a computer with multiple drawers that store a variety of medications that nurses and doctors can remove for individual patients. The UBCs are equipped with a variety of safety features to promote safe medication use. "Safety Stock" software incorporates barcode scanning during the restocking and removal of medications from the UBC. This ensures that the correct medication is restocked or dispensed. Customizable alerts provide additional safety. Some examples include: alerts for "sound-alike-look-alike" medications, such as hydroxyzine and hydralazine and alerts that provide instructions for proper medication administration.
Your Role In Medication Safety
We are very careful about making sure that you get the correct medicines intended for you. You can help make this process even safer by following the tips listed below:
- Be sure that your nurse identifies you by asking your name and date of birth before giving you the medicine. For patients who are unable to speak, the nurse will check the patient's armband for this information.
- Ask your nurse the name of the medicine and what it is for. Your nurse will tell you this information before giving you the medicine, but if he or she does not, ASK.
- Ask to see the container of your medicine, if you wish.
- Ask if there are any side effects, such as trouble breathing, rash, or swelling that you should report to your doctor and/or nurse.
- There also are important questions for you to ask when you are being discharged, including:
- Ask about the name, dose, and how often you should be taking any medications, especially new ones. Ask if there are special instructions for taking them, for example, if you should take them with food. Ask if a new medicine may react with medicines you will be taking at home, even over-the-counter or herbal medicines.
- Ask if there are any changes in the way you are to take medications you took before coming into the hospital. Sometimes, the dose or instructions will be changed.
- Ask about medicines you were taking that you do not see on your discharge medication list. Example: "I take Percocet for my back pain at home, should I continue to take that? It is not on the list." or "I take Centrum at home, can I continue to take this vitamin?"
- Ask what would happen if you do not take the medicine your doctor ordered, and what to do it you miss a dose by accident.