Medication Errors Common after Hospital Discharge

A new study indicates that over half of heart patients made medication errors or misunderstood instructions given to them about their medications after being discharged from hospital stays. The study highlighted the importance of medical professionals giving clear, easy-to-understand instructions. It also indicated that “health literacy” in general decreased the likelihood of risky medication errors.

This study is another indication that a person’s ability to interpret and act on health information strongly determines if a patient will correctly follow medication and care instructions. According to the CDC, a large percentage of the population does not have this health literacy. Around 20-30% of prescriptions are never filled, and over 50% of prescriptions are not finished or taken as prescribed. This indicates that medication errors by the heart patients in the study may be part of a greater trend of medication errors after hospital stays.

Factors That Influence Whether or Not a Patient Follows Care Instructions

Dr. Amanda Mixon and her team assessed 471 people hospitalized for heart failure, heart attacks, and related heart conditions in this study to determine which factors may influence a person’s likelihood of making a medication error. The study participants had an average age of 59 and almost half were women. The participants were given a health literacy test to gauge their understanding of health information and a numeracy test to measure basic math skills. Then doctors followed up with patients after discharging them from the hospital to see how well the patients followed medication instructions.

Over half the patients in the study made medication errors or misunderstood instructions given by doctors. One-fourth of patients left out one or more prescribed medications and more than a third were taking something that they were not supposed to take. Fifty-nine percent of the patients in the study misunderstood the purpose, dosage, or frequency of their medications.

The results did reveal some patterns in which patients were more likely to make errors. Patients scoring highest on the math skills test were 23% less likely to add or omit medications than low-scoring patients. Patients with the highest health literacy scores were about 16% less likely to make any medication errors. In general, people with lower cognitive function were more prone to medication errors.

Demographics had an influence on the study as well. Women were about 40% less likely to make a mistake than men were. Interestingly, single people of all ages were about 70% more likely to make a medication error than married people were. However, older people were increasingly more prone to medication errors.

The doctors involved in the study suggest that a screening tool could be helpful to determine which patients may be more likely to make medication errors. This would allow doctors to give added care to those who need it. Until something like a screening test can be comprehensively administered, doctors need to make sure to keep in mind patients that may need more information about medications, in order to fulfill their duty of care.


The Dangers of Gas Cans

Almost every home has gas cans. We keep them in our garages and sheds to fill up lawnmowers and other devices. These red, plastic canisters are about as ubiquitous as any other home accessory. For this reason, we never really think about the dangers posed by them.

Investigation has revealed many examples of horrific accidents related to children knocking over gas cans with tricycles, fathers filling up chainsaws or lawnmowers, or people just walking by a can that explodes. Just a small spark from static electricity or a water heater’s pilot light can cause the gas can to combust.

Blitz USA Defective Gas Cans

About 95% of all gas cans sold in the United States are made of plastic. According to the Consumer Product Safety Commission, about 19 million gas cans are purchased by consumers every year. About 75% of these plastic cans bought in the United States are sold by Blitz USA. The company chose not to use flame arresters in its design of plastic gas cans, which makes their cans especially prone to explosions as time passes.

Flame arresters have been used in metal gas cans for 100 years and they have effectively prevented explosions. Blitz USA even used them on their own metal gas cans. However, they chose not to include the simple metal device in their cheaper plastic models. Many plastic bottles containing flammable liquids and gases already include flame arresters, including lighter fluid. Although including flame arresters would minimally increase the cost of manufacturing the gas cans, the tiny cost is well worth the investment in safety.

Flame arresters are standard in most industries. In fact, workplace standard 1926.155(l) on fire protection and prevention from the Occupational Safety and Health Care Administration requires that all gas cans have flame arresters. The same standards of protection should be applied to consumers who have gas cans in their homes.

While Blitz has recently gone out of business, its successors, including Kinderhook, should be held to the highest standards. Safety should be the number one concern when it comes to manufacturing products that can be so dangerous. Legislation requiring flame arresters on every gas can is a top priority for consumer advocacy groups for the upcoming legislative session.


An Overview of Medication Mistakes in Hospital

In 2002, a group of medical professionals led by Dr. Kenneth N. Barker, director and researcher from Auburn University, performed a study concerning medication mistakes that occurred in hospitals. The findings were published in the September issue of “Archives of Internal Medicine.” During a four-day period, researchers assessed the medications administered or omitted. During the study, a licensed nurse or pharmacist accompanied and observed hospital nurses as each employee prepared and provided patients with medications. The researchers later compared observations with patients’ charts.

Medication Error Statistics

Out of 3,216 doses of medication administered, an error took place 19 percent of the time. Medications were given at the wrong time during 43 percent of the events. Patients were not provided a prescribed medication 30 percent of the time. Nurses prepared and administered the wrong dosage in 17 percent of the situations. In 4 percent of the administration events, patients received an unauthorized drug. The panel of physicians further found that the mistakes posed a potential threat to patients 7 percent of the time. This percentage equates to more than 40 occurrences every day at any 300-bed medical facility.

Complexity Part of the Problem

“BMJ Quality and Safety” published an article discussing human error in a number of industries that included the medical profession. According to the research cited, complexity plays a major role in the number of medication errors committed. Complexity is most commonly perceived as the number of steps required to complete a task. However, complexity also occurs with the degree of difficulty or the duration of tasks. Intensive care units, for example, exhibited a higher degree of medication mistakes compared with non-critical care units of hospitals. Similarly, the longer a patient remains in the hospital, the higher the risk that individual would become the victim of a medication mistake.

Strategies for Reducing Medication Errors

Minimizing complexity means reducing the number of steps required to complete a preparation and the administration of a medication. Improving product design may minimize the number of steps involved. Critical care units requiring healthcare professionals with advanced levels of education to manage and track patient care is thought to minimize the difficulty experienced by staff. Reducing the number of days patients spend in the hospital decreases the likelihood of error.

Patients now wear identification devices with bar codes that must match prescribed medications and treatments. Located in hospital pharmacies, computerized order-entry systems have the capability of receiving physician prescriptions directly, which eliminates possible errors from misinterpreting written orders. The technology also poses questions and emits alert messages that require pharmacist intervention to ensure the accuracy of an order.


Prescription Painkillers – What You Need to Know

Prescription painkillers are quickly becoming a problem for America. They can often be obtained much easier than illegal drugs, and there are many different age groups getting addicted and misusing them. Unfortunately, the increase in addiction rates coincides with an increase in overdose and death rates due to abuse of prescription pain medicines.

The Centers for Disease Control classifies this overdose as an epidemic. In 2008, about 15,000 people died from an overdose to prescription pain medications. The number of fatalities has more than tripled from the 4,000 deaths that occurred in 1999.

These numbers are so high because the medications are frequently prescribed. Painkillers are some of the most common prescriptions in the country. The problem is also due to access by illegal methods for those who are addicted. People are beginning to use painkillers when they are not medically necessary.

The prescription pain medications are generally safe and effective when they are prescribed properly, taken properly, and monitored carefully. They are not suited for relief from long-term pain, such as what may be experienced with fibromyalgia and rheumatoid arthritis. Pain experienced temporarily due to things such as injury and surgery is more successfully relieved.

Avoid leaving any unused pills around. If you have found that there are pills left after your pain is gone, they should be disposed of immediately. Take them to your pharmacy to be destroyed. The goal is to prevent you from being tempted to take them for other pain-related experiences, such as a bad headache or pulled muscle, when they are in a different dose than typically prescribed for your issue. Also, you want to ensure that other people do not have access to your unused pain medications.

If you are in one of the at-risk groups identified by the CDC, pay close attention to how you take the prescription. Middle-aged men are more likely to misuse painkillers than women or younger men. Also, residents of rural areas are more likely to be at risk than those who reside in large city areas.

Before you begin taking any prescription painkillers, it is recommended that you discuss the medication with your doctor thoroughly. Make sure you understand all the instructions, possible side effects, and potential interactions. Do not share the prescription with anyone and only take it as directed for the condition it has been prescribed.


Fraud, Conspiracy related to the Deadly Outbreak from PCA’s Peanut Processing Plan

The 2008 Salmonella Typhimurium outbreak traced to the now-shuttered company Peanut Corporation of America not only triggered severe sickness and even death, but also spurred a criminal investigation that has reverberations to this day. After nine deaths and more than 700 reported illnesses, the FBI launched an investigation into Peanut Corporation of America and its chief executives, including former CEO Stewart Parnell.

According to investigators, who spent four years looking into how the contaminated peanut products reached the market, Parnell and others in the company knew it was shipping dangerous products from its processing plants in Plainview, Texas, and Blakely, Georgia. The incident was a target for investigators because the resulting salmonella outbreak caused the largest number of recalls for one ingredient in the history of the United States. The outbreak not only affected hundreds of end consumers across the nation, but also forced Peanut Corporation of America into bankruptcy and caused companies who incorporated contaminated peanut pastes and butters into finished products millions of dollars.

Eventually, federal prosecutors brought criminal charges related to fraud and conspiracy against several Peanut Corporation of America figures, including former Vice President Michael Parnell, quality control manager Mary Wilkerson, and Blakely plant manager Samuel Lightsey. All four defendants posted bail and are awaiting trial.

Most recently, ex-CEO Stewart Parnell was in federal court in Albany, Georgia as his lawyers argued that expert witnesses should be permitted to testify as to Parnell’s Attention Deficit Hyperactivity Disorder (ADHD). If the court decides that experts may testify as to Parnell suffering from ADHD, it would bolster the former CEO’s defense and potentially allow him to shift blame to other defendants. Because crimes such as fraud tend to require that the defendant performed the criminal act knowingly, testimony about ADHD could be used to suggest that Parnell was not capable of managing or even keeping track of all of the complicated wrinkles of the conspiracy and fraud prosecutors allege took place.

In the United States court system, expert witnesses can testify with broader freedom than lay witnesses, and they are typically tasked with explaining difficult scientific or medical concepts. However, the court must verify that the expert is a legitimate one and is basing his or her opinions on valid, scientifically reliable data before the expert is permitted to testify. This is done via a pre-trial hearing, known as a “Daubert hearing,” based on a 1993 case involving a plaintiff of the same name.