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Guest Editorial
IT AND THE MEDICATION USE PATHWAY Medication misadventure and miscommunication is one of the most serious issues in healthcare, and it has particular ramifications for the elderly. In residential aged care, the adoption of a resident-centred IT model, with a single resident profile, ensures that every step in the medication pathway is catered for, including the prescription, the documentation, the dispensing and the administering of medications.
CHRISTINE VEAL BSc (Hons) Pharm AACPA Professional services pharmacist Webstercare
Medication misadventure is more common in the elderly and is associated with poor health outcomes. In Australia, medication misadventure is estimated to be responsible for 15 per cent of all hospital admission, 35 per cent of unplanned hospital readmissions and to cost the Department of Health $660 million a year.1 A known contributor to medication misadventure is the failure to communicate essential information. The aged care resident is particularly vulnerable to potential drug interactions, missing allergy information, miscommunication of the correct dose, or inadequate monitoring. To provide strength to an organisation’s clinical governance, IT solutions need to be secure, robust, be able to communicate and monitor medication safety and quality.
About the author Christine Veal is a professional services pharmacist with medication management specialist Webstercare, which developed the widely used Webster-pak. Webstercare also offers the MedsPro system using the Virtual Pill Count (VPC) software that is widely used in pharmacies that supply residential aged care facilities.
Medication miscommunication is a significant problem in the aged care industry and one which may result in over-medication, duplicated medication or omission of essential medicines. The impact on an individual resident may be profound and long-lasting. For example, not adjusting a resident’s dose of warfarin in a timely manner can result in severe bleeding and hospital admission. This misadventure could be avoided by streamlining communication
with the use of a secure messaging system to communicate between all members of the resident’s care team. While this is a potential tragedy for the individual resident and their family, it also affects staff confidence in the system they follow. In an article in the Australian Journal of Advanced Nursing2 nurses expressed concern about elderly residents being ‘warfarinised’, highlighting a lack of confidence in the clinical robustness of the current processes for monitoring warfarin use in the aged care setting.
The resident’s profile For the sake of robustness and accuracy, it is essential that there is only one central medication record for each resident. Adopting a resident-centred IT model ensures every step of the medication pathway is catered for, from the GP making the decision to prescribe, to documentation on the medication charts, dispensing and packing the medicines, identifying the right medicine and accurately administering it to the resident, documenting the administration process and monitoring all systems and outcomes. A single medication profile can be developed by integrating the medication order provided by the doctor, the administration history provided by the