Question

Annual pharmacy drug cost has increased from $10,300,000 to $16,800,000 in the past five years. The hospital is experiencing an increase in drug cost even though actual drug usage has remained stable. Along with the increase in drug cost, drug related errors have also increased. Patient safety has become an even more serious issue. As you know, patient safety is the number one item on the national health care agenda for the next several years.

At the hospital the number of dispensing errors has increased by two percent during the past twelve months. The registered nurses who are administering the drugs have discovered many of the dispensing errors; however, the ones not discovered resulted in patients getting the wrong drug, wrong dosage, and/or the wrong frequency. When the overall drug error rate was analyzed, it was found that dispensing errors in the pharmacy were the number one cause. The overall drug error rate had increased from three percent to five percent.

Fortunately most of the dispensing errors were discovered before the medications were administered to the patients. When the incorrect drugs were administered, it resulted in adverse effects in three cases. One patient received the right medication but the wrong dosage because the medication label was incorrect. This patient had to be admitted overnight to the Intensive Care Unit for intense cardiac and respiratory monitoring. The patient stayed in ICU for approximately twenty-four hours. Another patient received the wrong medication on the day of planned discharge and had to remain in the hospital for an additional day, though only for observation. In the third case, the patient had reported that he was allergic to a certain category of drugs, but nonetheless received a drug of that type. He had an adverse reaction–a rash–which delayed his discharge by one day.

On the basis of your understanding of the above case study, express your views on the following:

What measures should be adopted to reduce the overall drug error rate in the hospital?

What special benefits should be given to the patients who have suffered due to negligence by the hospital staff for wrong drug administration and other reasons?

In your opinion, should the hospital staff who were responsible for the dispensing errors be held personally liable for the errors? Why or why not?

Answer 1

CMC Drug Issues

A drug refers to any substance excluding food that when ingested by the body causes physiological changes in the body. Drugs carry a significant importance in the medical field and how they are used and administered to patients is crucial to any medical institution

First, at CMC the overall drug cost has increased over the past few years by a considerable amount of money, the increase in unwarranted as the drug usage remains stable. The situation acts a pointer to incompetence within the organization. The persons in charge of the administration of the drugs are failing at their work. Therefore; measures to reduce the increased drug error rates have to be taken. The measures include;

1. The persons administering the drugs should be well conversant with all the drugs and if he/she doesn’t understand the prescribing doctor should be consulted
2. All the drugs should get well labeled after they arrive at the hospital
3. The drugs should get categorized into the various ailments they treat making it easy to identify the right drug and know what drug needs to get ordered.
4. Before any drug is administered the prescribing nurse should double check with the doctor’s written prescription.
5. After administration of the medicine, the nurses should check if the right drug had got given to the right patient.

The administration of the wrong drugs to a patient is a significant medical error that may result in the death or threaten the life of a patient. Thus, great caution needs to get taken in the process. Patients who may have gone this need particular benefit as the error is as a result of the patients. Such patients should not get charged by the hospital for any extra costs that are incurred. They should also be compensated by the hospital if it leads to permanent damage to their bodies. Hospital staffs found responsible for the administration of the wrong drugs need to be penalized as this contradicts the work ethics code. The medicine field values the importance of life, and thus, the staff should be keen whenever administering the drugs.

In conclusion, I believe that the above steps if followed to the letter will help reduce the drug cost and dispensing issues that the hospital has been experiencing.