Malcolm Rivera
Hospitals have strict protocols regarding prescription drugs to ensure patient safety. While patients are generally discouraged from using their own medication during their hospital stay, there are circumstances in which this is permissible. This paragraph will explore the conditions under which a patient's own medication may be used in a hospital setting and outline the procedures hospitals follow to ensure the safe administration of prescription drugs.
| Characteristics | Values |
|---|---|
| Patient's own medication | Use is discouraged for safety reasons, unless the patient has a written order from a physician or authorized prescriber |
| Medication safety | Hospitals have processes in place to ensure patients receive the correct medicines, including prescriptions being sent by computer to the hospital pharmacy |
| Medication administration | The "Five Rights" checklist is used by nurses to ensure the right medicine is given to the right patient at the right time, in the right dose and by the right route |
| Medicare coverage | Medicare Part B covers a limited number of outpatient prescription drugs, typically those that cannot be self-administered |
| Self-administered drugs | Medicare Part B does not cover self-administered drugs in a hospital outpatient setting |
| Non-covered prescription drugs | If a patient receives non-covered prescription drugs in a hospital outpatient setting, they pay 100% of the cost unless they have other drug coverage |
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What You'll Learn
Patient safety
One key safety measure is the discouragement of patients bringing their own medications from home. This is primarily because the storage and handling of these medications prior to hospitalization are unknown, and there may be concerns about their safety and efficacy. However, hospitals recognize that in certain situations, such as with brand-name medications or epilepsy treatments, patients may prefer to use their own medications to maintain consistency and avoid adverse reactions. In such cases, patients may be allowed to use their own medications with a written order from a physician or authorized prescriber, specifying the medication, dose, frequency, indication, and route.
Upon admission, it is essential for patients to provide a comprehensive list of their current medications and dosages to the hospital staff. This information is crucial for the healthcare team to coordinate and ensure the continuation of necessary treatments. Hospitals typically have processes to verify and dispense medications safely. For instance, prescriptions are sent to the hospital pharmacy, where they are filled and labeled with essential information, including the patient's name, medication name, and dosage. This system helps prevent medication errors and ensures that patients receive the correct treatment.
Additionally, nurses play a vital role in medication administration. They utilize checklists, such as the "Five Rights of Medication Administration," to confirm that the right patient is receiving the right medicine, in the right dose, at the right time, and through the right route. This practice helps prevent medication errors and adverse reactions. Furthermore, nurses monitor patients after administering medications to observe their response and watch for any potential side effects.
Hospitals also have protocols in place to manage controlled substances and prevent misuse. Controlled substances are highly regulated due to their potential for misuse and use disorders. Prescribers and pharmacists must adhere to strict prescription writing and verification procedures to ensure the correct medication is dispensed. They utilize electronic databases, such as Prescription Drug Monitoring Programs (PDMP), to track prescriptions for controlled substances and identify suspicious patterns that may indicate misuse or illegal activity. These measures help prevent prescription drug overdose and abuse.
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Patient's own medication
Hospitals typically discourage patients from using their own medication during their hospital stay, primarily due to safety concerns. The primary concern is the unknown storage and handling of the medication before the patient's hospitalisation. However, patients may be allowed to use their own medication if they have a written order from a physician or another authorised prescriber, specifying the medication, dose, frequency, indication, and route. This medication is then given to a pharmacist for identification before administration.
In some cases, patients may prefer to use their own medication (POM) during their hospital stay, especially if they are sensitive to changes in brands or generic versions of drugs. POM use may increase patient involvement in their pharmacotherapy and improve their medication knowledge. Patients may feel more in control of their treatment and may be more receptive to counselling and information regarding their medication during hospitalisation.
POM use can also help patients maintain their regular medication schedule. For example, a patient with a liver transplant may bring a recorded list of their medications and dosages prescribed by their transplant team, requesting coordination with the hospital staff on any further medications. However, hospitals may have specific protocols and medication schedules that may not align with a patient's request, potentially leading to frustration.
Medicare Part B covers a limited number of outpatient prescription drugs under certain conditions, usually drugs that cannot be self-administered. For example, it covers drugs used with durable medical equipment, certain antigen allergy tests and treatments, HIV prevention drugs, injectable osteoporosis drugs, and erythropoiesis-stimulating agents for specific conditions.
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Medication identification
When patients bring their own prescription medications to the hospital, the use of these medications is generally discouraged due to safety concerns regarding their prior storage and handling. However, in certain cases, patients may be allowed to use their own medications during their hospital stay. This typically requires a written order from a physician or authorised prescriber, specifying the medication, dose, frequency, indication, and route of administration. The medications are then given to a pharmacist for identification before administration. If the medication cannot be identified, it will not be administered.
Pharmacists play a vital role in medication identification and safety. They are responsible for verifying prescriptions, ensuring accuracy, and checking for potential drug interactions or adverse reactions. Prescribers and pharmacists must work together to dispense the correct medications and verify all essential elements of prescription writing and verification. Additionally, they utilise prescription drug monitoring programs (PDMP) to track and monitor prescriptions for controlled substances, helping to prevent misuse and overdose.
In some cases, patients may be allowed to continue using their own medications to maintain familiarity and avoid potential issues with generic or alternative formulations. This can also reduce medication wastage and confusion during hospital stays. However, it is important for patients to inform their healthcare providers about any medications they are taking, including those brought from home, to ensure safe administration and prevent adverse drug interactions.
To further enhance medication identification and safety, patients are advised to keep a list of their medications, including names and timings. They should also actively ask about the medicines being administered, their purposes, potential side effects, and any other relevant information. This proactive approach empowers patients to identify and address any discrepancies or concerns regarding their medication during their hospital stay.
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Medication administration
Hospitals have strict protocols regarding medications to ensure patient safety. Generally, patients are discouraged from using their own medications during their hospital stay due to unknown storage and handling conditions. However, a patient's own medication may be used if a physician or authorized prescriber provides a written order specifying the medication, dose, frequency, indication, and route of administration.
Medication errors can have severe consequences, including adverse drug events (ADEs), which lead to injuries, extended hospital stays, or even death. To prevent such errors, it is crucial to have clear and legible prescriptions. Illegible handwriting and abbreviations can lead to misreading and subsequent administration of incorrect medications. Nurses play a vital role in detecting and preventing errors, and they should have the right to legible orders and correct drug dispensing.
Additionally, medication administration involves following established protocols, checking orders, effective supervision, and proper documentation. Procedural barriers and 24-hour pharmacy coverage can help reduce the risk associated with accessing high-risk drugs. Error reporting strategies are essential, and ongoing reporting is necessary for continuous quality improvement. Nurses should be encouraged to voluntarily report medication administration errors to identify and address the causes and implement effective solutions.
Furthermore, medication reconciliation is an important aspect of medication administration, ensuring that patients' medication histories are accurate and up-to-date. This process involves good decision-making skills and clinical judgment on the part of nurses, who must have a full understanding of the medications and their implications for patient safety.
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Medication coordination
Patient's Own Medication:
Hospitals generally discourage the use of a patient's own medication during their hospital stay due to safety concerns. The storage and handling of these medications prior to hospitalization are unknown, and improper storage or handling could affect the efficacy and safety of the drugs. However, a patient's own medication may be used if there is a written order from a physician or authorized prescriber. This order should specify the medication, dose, frequency, indication, and route of administration. The medication is then given to a pharmacist for identification and verification before administration.
Medication Verification and Administration:
To ensure patient safety, hospitals have rigorous processes in place for medication verification and administration. Typically, a patient's provider or nurse will send a prescription to the hospital pharmacy, either electronically or via a verbal order. The pharmacy staff will then fill the prescription, labelling it with essential information such as the patient's name, medication name, dose, and other relevant details. The medication is then sent back to the patient's hospital unit for administration. Before administering the medication, nurses will confirm the "Five Rights" of medication administration:
- Right medicine: Ensuring the correct medication is being given.
- Right dose: Confirming the amount and strength of the medicine are accurate.
- Right patient: Verifying that the medicine is intended for the right patient.
- Right time: Determining if it is the appropriate time to administer the medication.
- Right route: Confirming that the medication is being administered through the correct route (oral, intravenous, etc.).
Coordination with Medical Team:
Effective medication coordination requires collaboration between the patient, their medical team, and the hospital staff. Upon admission, it is essential to inform the hospital staff about any current medications, dosages, and relevant medical history. This information helps the hospital coordinate with the patient's medical team to ensure medication continuity and avoid potential drug interactions. Patients should also keep a list of the medicines they receive in the hospital, including the names and timings, to ensure they understand their treatment plan.
Discharge and Ongoing Care:
When a patient is discharged from the hospital, they may be sent home with their own medications brought from home or with a new supply of medicines. It is common to have a mix of both. Patients should feel empowered to speak with the ward nurse or pharmacist if they have concerns about their medications upon discharge. Additionally, patients should understand the purpose of each medication, potential side effects, and any specific instructions for administration at home.
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Frequently asked questions
Yes, you may bring your own prescription drugs to the hospital. However, the use of a patient’s own medication is discouraged for safety reasons, as the storage and handling prior to hospitalization are unknown.
You may use your own prescription drugs in the hospital if you have a written order from a physician or other authorized prescriber. For each medication, the order should specify the medication, dose, frequency, indication, and route.
When you bring your own prescription drugs to the hospital, they will be given to a pharmacist for identification. If the medication is identified, it will be administered to you. If not, it may not be administered.
If you want to use your own prescription drugs in the hospital, make sure to inform your nurse and provider. Provide them with a list of your medications and dosages, and ask them to coordinate with your medical team.
