Surprisingly, giving prescriptions to the wrong patients is still common in community pharmacies across the United States. According to the Institute for Safe Medication Practices (ISMP), this error occurs about once in every 1,000 prescriptions dispensed.
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In its July 2015 issue of ISMP Medication Alert!, Community/Ambulatory Care, ISMP listed the top steps pharmacies can take to practically eliminate the risk of a patient taking home another patient’s medication by mistake. They include:
- At the point-of-sale, have the patient review the pharmacy labels and contents of each prescription container to check that the medication is correct – even if this requires opening the bag. “This simple step alone can cut the risk in half of patients taking home a correctly-filled prescription intended for another patient,” ISMP wrote.
- Ask the patient to provide 2 identifiers – their full name and date of birth-when picking up prescriptions. “This is important even if you ‘know’ your patients. Compare their answer to the information in the computer system or on the prescription receipt,” ISMP wrote.
- Talking to the patient about their medications reduces the risk of taking home the wrong medication by another 25%, according to ISMP. “Pharmacists should engage the patient in dialog by asking questions that do not have ‘yes’ or ‘no’ answers. Patient education sessions should include a discussion of the medication’s purpose, to help ensure the correct medication is being dispensed to the correct patient,” ISMP wrote.
- Explore technological enhancements at the point-of-sale that require pharmacy staff to verify the patient’s identity. “For example, consider building a blind prompt that requires the pharmacy staff member to ask for the patient’s date of birth and then key punch it into the register. If the date of birth does not match the patient’s profile or is not entered, the transaction cannot be completed,” ISMP wrote.
- Flag patients with similar names in computer systems. “Alerts should appear when these patients are selected during data entry. These flags should also be visible at the point-of-sale,” ISMP wrote.
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