The typical process of medication management within a care home setting is complex and requires many essential steps, various information sources and the involvement of internal and external healthcare professionals.
Strengthening these interdisciplinary partnerships and streamlining the workflows that support medication administration will play a critical role in protecting elderly residents from the adverse events caused by medication errors.
According to the Care Homes Use of Medicines(CHUM) study, errors occur on 8.4% of medication administration events. That would mean that a care home resident being administered medication three times a day, would have an 84% chance of receiving a medication administration error every week and a 99.9 percent chance every month.
To give credit where credit is due, there are signs that medication standards in care home homes have improved dramatically in the last decade. The Care Quality Commission has reported that the proportion of care homes meeting or exceeding that national minimum standard on medication had jumped to 70 percent by 2009. But there is still room for improvement, with a significant amount of care home medication errors being preventable.
Preventable medication errors and discrepancies are caused by a combination of factors. Firstly, the use of multiple medicines by residents is common in care homes, given their complex care needs. In the Centre for Policy on Ageing’s Managing and Administering Medication in Care Homes for Older People, it is suggested that care home residents are, on average, prescribed seven to eight medications. Using this statistic, it is reasonable to assume that a 100 bed care home would be administering about 700 to 800 medications to residents per day.
Now consider that the primary tools being used by the majority of care home providers to manage their residents’ medications still largely revolve around paper-based systems with significant limitations. It becomes very challenging to provide the highest levels of safe and quality care, while using a manual approach to administer such large volumes of medications.
We are witnessing more and more care homes taking necessary steps to improve medication management. By restructuring and investing in electronic medication management (EMM) systems, many providers are achieving an immediate and substantial reduction in preventable medication errors.
Apart from the obvious need to reduce the risk of harm to residents, implementing EMM systems within care homes can result in organisation-wide efficiencies. Below we have outlined six ways that your organisation and its employees can enhance medication administration outcomes with the implementation of EMM.
In a typical care home, drugs are administered by trained care staff at appropriate intervals throughout the day. There are usually three to four medication rounds per day, which are demanding, time-consuming and often laden with interruptions.
In fact, the CHUM study described interruption during medication rounds as ‘frequent’ or ‘constant’ and identified interruptions as the most significant contributor to medication errors. Not surprisingly, they can also lead to serious compliance risks.
EMM systems outperform paper-based systems in this regard, with intuitive alerts and warnings that automatically prompt staff to comply with the highest standard of medication administration procedures.
The systems enable care home providers to safeguard against compliance risks associated with the administration of PRN ‘as required’ medications. EMM systems ensure staff coordinate, administer and track PRNs with greater efficiency, by capturing a detailed history for each resident, as well as documenting the reason why the PRN was administered.
EMM systems that integrate with electronic record systems also allow this information to be automatically updated and recorded within daily notes, eliminating the need to rely on human memory. This ensures overall greater accuracy and more effective evaluation of PRN medications.
Paper-based systems force staff to spend valuable time searching through paper-based records when determining what medications are due throughout any given medication round. This process is not only lengthy, but increase the likelihood of discrepancies and errors.
An EMM system offers a tangible boost to efficiency and productivity by saving staff from manually sorting through paper-based medication records to determine what medication is due at what time.
EMM systems support centralised, electronic medication administration records (eMAR) allowing staff to only view the medications that are due to be administered within a given time period. To further support efficient medication administration, important information about each residents’ preferences can be accessed at the point of care, accompanied by photo identification.
Care homes are usually responsible for checking in, administering, ordering, reordering and disposing of medications. Registered and enrolled nurses in care homes are therefore responsible for the daily managements of hundreds, if not thousands, of medications for residents.
EMM reduces the pressure of these tasks by providing a centralised electronic record that can be accessed by all authorised staff working within the care home.
The greater control and transparency provided by EMM systems enables you to reduce the amount of admin undertaken by staff, so that you can increase your capacity, and care workers can spend more of their time on the things that enhance care quality, like spending more time with residents.
In addition to improving workflows, EMM systems also alert staff to potential safety issues or any missed steps relating to the administration of medication. This helps ensure your medication administration processes and records are carried out to the highest standard.
With functionality to electronically capture data and centralise information in one system, EMM also increases visibility of medication management processes throughout multiple care homes, which adds a whole new dimension of control, safety and quality improvement to businesses with mutliple care homes to take care of.
EMM enables management to obtain access to data in real-time including medications administered, medications missed, PRNs and more. This data can be accessed at any location within the organisation, without the need to rely on transporting paper-based records.
This electronic data can also be analysed to improve decision making affecting operations, staff and resident health outcomes.
Although the features of EMM systems significantly improve the actual process of administration, the improvements to the medication ordering process are also important.
Especially when you consider the CHUM study also found that half of all communication-related medication errors occurred between the care home and the pharmacy.
EMM systems that can integrate with pharmacies give a clear and transparent flow of communications between the care home and the pharmacy, which are are recorded electronically.
This means every interaction can be tracked to help eliminate the uncertainties around medication dispensing, and achieve optimal medication management. EMM is already proving to be a key enabler in reducing communication-related medication errors, improving safety and the effective delivery of care.
The entire social care sector faces challenges with recruiting and retaining qualified staff. These challenges are compounding due to an overall shrinking workforce and increasing workloads for those who remain in the industry.
Taking advantage of EMM systems can reduce the demands on care home staff and improve the overall care experience for all involved.
EMM systems free staff from the intensive documentation and administrative duties that paper-based systems cause, providing more time to focus on providing high quality care for residents.
In our own experiences, EMM systems are quickly embraced by staff in care homes because they are easy to use and do not add to existing workloads. Instead, they are designed to complement the processes and information associated with existing clinical systems.
Understand where most errors occur, including the most serious ones and how these can be prevented or reduced:
Getting the selection and implementation of your medicine management system right will determine its success and your ROI. This guide uses industry experts so you get the most from your investment.
Hear from leading residential care providers on their own experiences of using Electronic Medication Management what have the key benefits been and what is their advice for other providers?
How many medicines do care homes give to residents on average and what is the chance of error? What causes medication errors in care homes and where do they happen, at administration or management level?
Learn how operators of care homes and nursing homes are gaining control over their medicine processes to reduce risk and be more efficient. What processes and systems like eMAR are they using?
WHITEPAPER: eMAR - Is it for me?
Will eMAR benefit you? We think so. Find out how an eMAR system will benefit you, reduce risk and improve the care you provide, by having a read of our whitepaper. We highlight key features of eMAR and the importance of a medication administration system to make it clearer for you when deciding.
FACTSHEET: Medication Management Software and eMAR
Understand what a complete system for medication management in care homes and nursing homes looks like including medication administration, stock control and eMAR
CASE STUDY: Erskine Care Case Study
Erskine Care Homes in Scotland have been using Access Medication Management . With the software, their processes of administering, ordering and monitoring medicines have significantly improved in efficiency, along with totally eradicating missed medication. Find out how the system has helped them.
ARTICLE: The battle of medication management and how to prevent errors
Medication management in domiciliary care doesn’t have to be a struggle, especially with medication error prevention strategies in place. We summarise the risks of incorrectly giving our medication in care homes and look at how systems can be used to prevent errors – making sure your practices are in line with CQC guidelines.
ARTICLE: EMAR and EMM – What is the difference?
It’s good to have a detailed understanding of the difference between eMAR and EMM. There are clear differences between them both and we’ve outline the key information in this quick blog.
ARTICLE: CQC research identifies the key medication issues across social care
The CQC have looked at key themes and issues with administering and managing medication across the care industry. Find out what these are and how they correlate with the use of software and new technologies.
ARTICLE: The Care Quality Commission's (CQC) responses to Electronic Medication Management in residential care
Find out why the CQC are onboard with the use of EMM and examples of when the system has stepped up a home’s CQC rating.
CASE STUDY: Hallmark Care Homes
An easy to use system which saves time on paperwork and frees the time of care workers and management staff is one of the main goals of an eMAR system. Find out how two of our systems have worked hand in hand with the team at Hallmark Care Homes, to make the day-to-day easier.
ARTICLE: Polypharmacy. What is it? How to deal with it?
There is no hard and fast definition for what constitutes polypharmacy, but it has often been described as the use of four or more medicines on a daily basis. In this article, we explain what polypharmacy is and the risks that are associated with it.