Articles Posted in Patient Safety

Amazon is one of the most valuable companies in the United States, and is getting even more and more utilization during the COVID-19 pandemic, as Americans order an increasing amount of things online, from groceries to pet supplies, books, and décor. Now, Maryland shoppers may be able to get one more thing from this giant retailer: their prescriptions. Last month, Amazon announced the launch of Amazon Pharmacy, a delivery service for prescription medications. The service would allow Amazon customers to purchase prescription drugs with or without health insurance, which Amazon claims will save them money, up to “80 percent off generic and 40 percent off brand name medications when paying without insurance.” Is is unclear, however, how Amazon Pharmacy could impact the prevalence of Maryland pharmacy errors.

While the potential savings on drug prices sound great, experts say that Amazon Pharmacy is likely not going to be a game-changer when it comes to the high cost of prescription medications.  Customers may enjoy some savings, but this online option is likely to work similarly to other online pharmacies and cannot solve the large and complicated problem of U.S. drug pricing. Still, professionals are watching to see what impact Amazon Pharmacy has and how many Americans utilize it for their medications.

Maryland pharmacy errors are a persistent problem, sometimes causing severe injury or illness. And, unfortunately, anyone who has ever ordered something online can tell you that online shopping does not always go off without a hitch—sometimes the wrong product or item can be sent, items can be swapped with others, or a package could get lost or never arrived. Pharmacy safety advocates should watch closely to see whether or not Amazon Pharmacy falls prey to the same errors that occur in pharmacies every day. It’s very possible that pharmacy errors continue to plague Maryland patients, regardless of where they get their prescription.

Laws vary from state to state regarding the authority of certain persons to dispense medication. In Maryland, physicians are permitted to dispense medication subject to certain regulations. Maryland physicians who are permitted to dispense medication must obtain a dispensing permit from the Maryland Board of Physicians. But the ability to dispense medication poses additional avenues of liability for physicians and raise concerns among some and may pose additional risks for Maryland patients, as one recent article showed.

The article raised the issue of whether physicians should be permitted to dispense medications. In an editorial in another paper, a writer had suggested that it is a good idea to have doctors dispense medications directly to patients, because it may be easier and cheaper for patients. Three doctors in Montana recently filed a lawsuit seeking to be allowed to dispense medications directly to their patients. Dispensing medication directly to patients is prohibited in that state. However, critics say that dispensing medication directly to patients raises serious medication safety concerns. In particular, there is a concern that there would not be a second review by a pharmacist of the prescription. There is also a concern about the lack of regulatory oversight, such as labeling, supervision, and storage.

Pharmacy errors can occur at different stages in the process. Having a pharmacist dispense and administer the medication means that the pharmacist can act as a check on errors that can occur when prescribing medication. Allowing a doctor to prescribe and dispense a medication means that there would likely be no second person reviewing and checking for errors before the medication reaches a patient. Prescribing errors can, of course, cause significant harm to patients.

Maryland pharmacy errors occur when a patient is given a prescription drug that is flawed in some way. It may be the incorrect drug, or the incorrect dosage, or it may be that the instructions are incorrect, causing the patient to take the drug too often, not often enough, or at the incorrect times. Because prescription drugs are often powerful and dangerous if taken incorrectly, pharmacy errors can cause severe illness or injuries, especially if they are not caught for a significant period of time.

Patients can protect themselves from Maryland pharmacy errors by carefully reading the drug labels and prescription information every time they pick up a prescription. These labels not only provide important information on safe and proper medication use; they also can help the patient check for errors. For example, the information provided with the prescription often indicates what the medication looks like, by describing it as “small white pills” or “red oblong capsules.” Patients should compare this information to the actual medication they receive, to ensure there has not been a drug mix-up.

Additionally, the information included with the prescription explains how to use the drug and drug interactions. This information should be compared with instructions given by your doctor or pharmacist. If there’s a conflict, it’s safest to call your doctor or pharmacist to clarify. The information on drug reactions can also help patients avoid a common pharmacy error—doctors prescribing a medication that has an adverse interaction with another medication the patient is already taking. If you are already taking any form of medication, even if it’s over the counter, it is best practice to read the information on drug interactions provided with your prescription drug to make sure there are no problems.

It’s no secret that the COVID-19 pandemic has overwhelmed the health care system. High rates of infection and death have sent thousands of Americans to hospitals and health care clinics, most of which were already busy treating patients before the pandemic. The country’s medical providers and health care workers are working hard every single day to try and help people and combat the virus, but the sheer amount of work and stress they are under may take a serious toll on their mental health and their ability to perform the job effectively. Recently, a hospital nurse spoke to the Institute for Safe Medical Practices (ISMP) about the impact that COVID-19 is having, and what he said has implications for how the pandemic may increase Maryland pharmacy errors.

According to an article detailing his experiences and report, medication errors have been increasing in his hospital. Because nurses are working long hours with critically ill patients in a stressful, hectic, and overwhelming work environment, medication errors are more common. However, it is likely that this pattern is not isolated to just hospitals. The entire health care system is overwhelmed right now that it is likely that the rise of medication errors is also occurring in other settings, including pharmacies.

Pharmaceutical errors can be just as dangerous as errors occurring in hospitals. Many Maryland residents rely on their local pharmacy for their medications, but when pharmacists and pharmacy technicians are stressed out and overwhelmed they may make significant errors, such as providing the wrong dosage of a medication, or even the wrong medication altogether. With the COVID-19 pandemic, pharmacies may be overwhelmed by more calls from patients than usual, or requests for more prescriptions as individuals stock up. They may also be short-staffed if a pharmacist or technician gets sick or needs to stay home to take care of a family member. All of this can negatively affect Maryland residents, who rely on pharmacists to fill their prescriptions correctly and likely to not expect to be injured from taking prescribed medicine.

The COVID-19 pandemic had changed the lives of almost every American in too many ways to count. Among those who have been the most impacted by the pandemic are medical workers, including pharmacists. Pharmacies have seen surges in volume as more people are more frequently visiting doctors and obtaining prescriptions for all types of health conditions. As the demand on pharmacists increases, so does the risk of a Maryland pharmacy error.

The Institute of Safe Medication Practices has released a list of tips that pharmacists should follow to decrease the risk of error during these challenging times. The tips are broken down into three categories:

Preventing Pharmacy Errors

When it comes to preventing Maryland medication errors, the Institute of Safe Medication Practices recommends pharmacists take the following steps:

  • Keep certain IV infusions standardized to a single concentration or dose, when possible.
  • Use visually identifiable premixed solutions for common infusions.
  • When dispensing a nonstandard concentration or a paralyzing agent, be sure to clearly label these infusions.
  • Implement frequent safety meetings and create processes for pharmacy members to double-check solutions before administering infusions.

Continue reading ›

Maryland residents may rush to get a COVID-19 vaccine when it becomes available. Yet, as companies race to develop a COVID-19 vaccine, questions about the risks of a vaccine have been raised. All vaccines carry some risk for residents of a Maryland medication error, and according to a recent news report, many experts have speculated on the heightened risks of a COVID-19 vaccine in light of a condensed development timeline.

Experts in the public health field worry that a condensed timeline for developing and testing the vaccine might mean that it is approved without proper data and analysis. Some of those fears appear to have merit. One vaccine testing candidate did not test in animals. Another experimental vaccine was approved for China’s military before trials were even completed. A significant number of people in one vaccine trial experienced a “medically significant” adverse event. Creating a vaccine in the span of a year is “unprecedented,” according to one expert working to develop a new vaccine platform.

Some experts worry that the vaccine will not be safe or effective. A vaccine might produce unintended side effects, for example. One adverse event that had been seen with vaccines for other viruses is an antibody-dependent enhancement (ADE). An ADE is an immune reaction to the vaccine that makes subsequent exposure to the virus more dangerous by generating antibodies that encourage the virus to replicate instead of neutralizing it. One scientist said that the rare side effects of a vaccine likely will not be discovered until after the vaccine is approved.

Recently, the Pharmacy Times published an article detailing how pharmacy technicians can play a critical role in preventing pharmacy errors. Maryland pharmacy errors can cause serious injuries or illness, leaving those affected with potentially lifelong medical issues. According to the article, the role of pharmacists continues to expand to include more and more duties, meaning that pharmacy technicians are needed more than ever to fill in the gaps. Every year, there are approximately 7 million preventable medication errors. One of the most common errors is incorrect dosing—the Pharmacy Times writes that they make up about 37% of errors each year.

So how can pharmacy technicians help? The technicians are often the first line of defense and best suited to catch errors and prevent them from happening. They are often the ones who type up the prescription, and the ones who take prescriptions from the patient at the counter. They are uniquely situated to prevent pharmacy errors before they happen by double-checking medications.

One experienced pharmacy technician says that all technicians should use a set of “patient rights” while checking medications. Her five steps are designed to help pharmacy technicians systematically check for errors. First, a technician should ensure they have the right patient and ask them to identify themselves. Second, the technician should ensure they have the right medication. Third, the technician should make sure they have the right dose and instructions for how to take the medication. And finally, the technician should confirm the time of the last dose and frequency.

The novel coronavirus or COVID-19 has drastically impacted life for Maryland residents and businesses. Pharmacies across the state and the nation have been particularly affected. Pharmacies are a vital part of the healthcare system and have needed to remain open during the pandemic. However, if pharmacies are not careful, they may be doing more harm then good, by contributing to the spread of COVID-19 and causing more and more Americans to fall ill.

The Centers for Disease Control and Prevention (CDC) have been regularly updating guidance for pharmacies on their website. The guidance recommends that everyone entering the pharmacy should wear a face mask or covering, regardless of whether or not they have symptoms. This includes both customers and pharmacists. Also, pharmacists are encouraged to limit contact with customers as much as possible, by maintaining a social distance of at least 6 feet, placing the prescription on the counter for them to pick up instead of handing it directly to them, and using hand sanitizer frequently.

Importantly, the guidance also advises pharmacies to ensure that staff who are sick stay home. Pharmacists and other staff members may come to work even when they have a fever or other COVID symptoms, including body aches or a cough. While they may not want to work while sick, their employer may not have an adequate sick leave policy, and employees may fear losing their job if they request time off. Now more than ever, pharmacies need to ensure that they create policies that allow their employees to stay home when sick, and then encourage their employees to take advantage of these policies.

Technology is a crucial component of the healthcare industry. Not only do advancements in technology help pave the way for new medications and treatments, but they also lead to the development of new processes that may reduce the risk of a Maryland pharmacy error.

Recently, we wrote about pharmacist burnout being a significant contributor to Maryland pharmacy errors. While pharmacists typically work long hours, that is especially the case with the ongoing COVID-19 crisis. Thus, the issue of pharmacist burnout is a topical one in need of a solution. According to a recent news report, some experts are suggesting that pharmacists use vending machines to reduce the instances of errors.

While some countries have used vending machines for over-the-counter medications, for the most part, the United States has yet to do so. According to a proponent of the idea, vending machines could be stocked with common over-the-counter and prescription medications. The WIFI-enabled machine would have its own address to which physicians could e-prescribe medication. After a physician prescribed a medicine, the patient would go to their local pharmacy, type in their information, and receive the medication. Proponents of the vending machines agree that while some prescription drugs would be included in the machines, controlled substances would only be available through the pharmacist.

When a Maryland patient receives a prescription from a pharmacist, they typically trust that the pharmacist has given them the correct medication and the correct dosage. Unfortunately, this is not always true. Pharmacists make mistakes far too often while filling patients’ prescriptions, and these mistakes can have long-lasting consequences and lead to illness, injury, or even sometimes death. Fortunately, however, there are things Maryland residents can do to protect themselves from pharmacy errors. The New York Times recently published an article detailing five things patients should do when getting a prescription from a pharmacy.

First, patients should talk to the pharmacist dispensing their drugs. Pharmacists are knowledgeable about drugs, common issues with drugs, and how they may interact with other medications someone is already taking. Talking to the pharmacist also increases the chance that they will take a second look at a patient’s prescription, hopefully catching any errors. This precautionary step is especially useful if it is a new medication, since patients may not know what the pill is supposed to look like and won’t immediately notice errors.

Second, patients can protect themselves by taking a few seconds right inside of the pharmacy to open the bag. According to Institute for Safe Medication Practices, one of the most common pharmacy errors is dispensing a prescription to the wrong patient. Take time to check that the correct name of the patient is on the bag as well as on the box or bottle inside the bag. In this instance, patients may be able to fix a pharmacy error before it even leaves the pharmacy.

Contact Information