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 Recent studies indicate that approximately
20% of patients discharged to home from a hospital will
experience an adverse event during this transition and
that over two-thirds of these events are drug-related.
In fact, any move of a person from one setting of care
to another can introduce the risk that a needed medicine
might be forgotten or overlooked, or that the order
for the medicine might accidentally be written with
the wrong dose. The person's medical
records sometimes might not be readily available.
Another problem when people leave the hospital is that the doctor who provided care in the hospital may be a different doctor than the one who will provide care after the hospital discharge. These doctors may sometimes have difficulty sharing information with each other to make sure that the person's medical care and medicines continue to be managed consistently.
For a variety
of reasons, medication errors can occur during these
care transitions. Since older adults frequently take
more medicines than younger persons, their risk for
problems may be higher.
Reducing Your Risk
The most important
principle in preventing errors during
moves from one care setting to another
is that the patient must play an active
role in coordinating care.
Having
a family member or friend to help is
a good idea.
There are ways to reduce the risk
of medicine problems during a move
to or from the hospital, nursing home,
assisted living, or other care setting.
The most important step is to keep an
updated record of all the medicines
you take, including any over-the-counter
medicines, herbal products, and dietary
supplements. You can use this Personal
Medication List form to keep track
of your medicines. Remember to update
the form, or ask your doctor or pharmacist
to help you update it, each time your
medicines are changed.
Keep your medication list in your purse
or wallet so that it can be used in case of an emergency.
The list won't do you any good if you don't have it
with you when you need it.
Older adults should have one doctor that serves as the primary care or general physician. Although older adults may see a number of specialists for various problems, it is helpful to have one physician that oversees all the care provided and helps to coordinate with the specialists.
Many hospitals today employ hospitalists. These are physicians who provide care to persons during their hospital stay, but are generally not involved in the care of persons before or after their hospital stay. For this reason, it is especially important that persons who are discharged from the hospital make sure that their primary care physician receives a report from their hospital stay.
When you go to the hospital:
- Take your medication list with you
so that the doctors and nurses will know what you
are taking.
- Make sure you tell the hospital
staff about any allergies you have to medicines
or other substances, such as foods. It does not hurt
to remind the nurse about your allergies before you
are given medicines.
- Do not let anyone give you medicines without checking your hospital ID bracelet every time. This helps prevent you from getting someone else's medicines.
- Look at the medicines before you
take them and ask questions if you have any, especially
if the medicine looks unfamiliar.
- If possible, arrange for a family member or friend to be with you as much as possible when you are in the hospital. Ask this person to help you check to make sure that you receive the correct medicines.
- When you are ready to go home, have
the doctor, nurse, or pharmacist go over each medicine
with you and a family member. Update your medicine
list from home if any medicines have been added, changed,
or discontinued.
This brochure, Taking Care of My Health Care, may be helpful to you and your family members in helping to manage your health care.
This video, Communicating with Your Doctor, may be helpful also.
Who Can Help?
Some health professionals have been especially trained to help older adults and can be especially useful during transitions of care, such as discharge from the hospital.
A geriatric care manager is often a social worker or nurse who has special training in assisting older adults and family members with the special needs of the older adult. To learn more about geriatric care managers, or to find a geriatric care manager in your area, check the Web site of the National Association of Professional Geriatric Care Managers.
Because medicines are such an important part of the care provided to most older adults, a senior care pharmacist can be especially helpful. These pharmacists have training and experience in working with older adults and their doctors to help ensure that medicines are being used in the best way to achieve the desired goals. For more information about senior care pharmacists, or to find a senior care pharmacist in your area, go to this Web site: http://www.seniorcarepharmacist.com.
Some senior care pharmacists have passed an examination to become a Certified Geriatric Pharmacist (CGP). For more information, check the Web site of the Commission for Certification in Geriatric Pharmacy: http://www.ccgp.org.
A physician who specializes in care of older adults is called a geriatrician. The United States has only about 7,000 geriatricians and over 35 million older adults. So, most older adults have a primary care physician who does not have specialized training in geriatrics.
A gerontological nurse practitioner is a nurse with advanced training in the care of older adults. These persons often serve as primary care providers in conjunction with physicians and can prescribe medicines in most states. More information is available from the Gerontological Advanced Practice Nurses Association: https://www.ncgnp.org.
Other Resources
Listed below are links to other resources
and information to help keep you safe during transitions
from one setting of care to another.
- The National
Transitions of Care Coalition is a coalition of
29 national organizations that is working to reduce
medical errors that may occur when people move from
one setting of care to another.
- The SOS-Rx
Coalition is composed of more than 70 organizations
and is focused on enhancing the safety of medication
use by consumers, especially older adults. The coalition
is developing resources to help advance this mission.
Go to the Links page for additional resources.
 This section sponsored by sanofi-aventis U.S. LLC
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