Nursing home staffs manage drugs and treatment plans for hundreds of patients receiving short and long-term care in a facility. Yet, as more and more homes see their nursing staffs shrink and the patient pool grow, the margin for error increases. As a result, medication errors are unfortunately becoming a common problem in nursing homes.

In terms of how frequently they occur, states have a five-percent standard based on Medicare and Medicaid regulations. When a home’s rate exceeds five-percent, the nursing home receives a deficiency citation by the state’s inspection team, which leads to an investigation. In response, a nursing facility must implement a plan to get the number of medication errors under that five-percent mark.

However, nursing homes’ rates might be higher than reported. According to a 2014 study published in ProPublica, nearly one in three patients in a skilled nursing facility may experience some kind of medication or treatment error during their stay. The report further determined that 59 percent of all related injuries were preventable and half of those harmed had to be re-admitted to a hospital. Only 1.5 percent from this group experienced a fatal injury.

So, what constitutes a medication error and why do they occur so often? This broad scenario encompasses several factors:

Common Types of Errors

Nurse filling out a formMedication errors in nursing homes are divided into three large groups:

  • The nursing staff didn’t follow the doctor’s orders.
  • They didn’t follow the manufacturer’s instructions for administering the drug.
  • They went against professional standards concerning the medication.

Within these parameters, an error may occur when:

  • Nursing staff crush or split a pill that should be kept whole.
  • They don’t provide the patient with sufficient fluid to take the medication.
  • The medication may not be rolled or shaken properly.
  • Based upon recommendations, the medication isn’t correctly administered with enteral nutritional formulas (ENFs), eye drops or metered dose inhalers.
  • Staff give elderly patients sublingual tablets.
  • They don’t supply the patient with food or antacid to take the medication.

Additionally, errors are more likely to occur during the “med pass,” when a nurse passes out drugs to all patients in a facility. During this procedure, a staff member needs to make sure all patients receive the correct medications in accordance with doctor’s orders. However, the following have been known to lead to an error during “med pass”:

  • A nurse gets distracted by one patient and mixes up medications.
  • There are not enough drugs available, so the nurse borrows one patient’s medication to give to another patient. In turn, the first patient doesn’t receive the correct dosage and may run out of medication sooner than expected.
  • The nurse steals a patient’s medication for personal use, preventing a patient from getting sufficient treatment.

Due to the frequency of med pass, repeat medication errors are more likely to occur. In fact, data indicates repeat errors have a 37.5-percent occurrence and cause patients the greatest degree of harm.

Negligent Errors and Malpractice

There’s a fine line between an error and negligence or malpractice. In fact, an error may be considered negligent or medical malpractice in the event of the following occurrences:

  • A patient experiences a medication overdose.
  • A patient continues to receive expired, potentially harmful drugs.
  • Staff continue to give a patient the incorrect drugs or medication strength.
  • Staff continue to use incorrect techniques when administering medication.
  • Staff use or file away incorrect documentation for the patient.
  • Errors with lab work lead to misdiagnosis.
  • Nurses continue to follow an incorrect med pass route, giving multiple patients the wrong drugs.
  • Staff members ignore a doctor’s medication orders for a patient. In certain cases, this scenario arises from poor communication between doctors and nursing staff. In others, nurses may intentionally ignore a doctor’s recommendations.
  • A patient’s medications aren’t renewed, so he or she goes without treatment.
  • Staff members don’t look at a patient’s medical records. In this scenario, doctors and nurses don’t factor in negative drug interactions or patient allergies.

Other Scenarios

Confused patients or individuals whose family members have managed their care have been known to provide inaccurate information to a nursing home staff member. In this scenario, an elderly patient might not know which medications and dosages to be taking and may provide staff with an incomplete or incorrect list. As a result, patients may receive a medication they shouldn’t have been taking, may miss doses or may receive the wrong dosage of a prescribed medication.

On the other hand, a doctor overseeing a home’s patients may misdiagnose an individual. In this case, the doctor’s recommendations lead to unnecessary, potentially harmful treatment and medications.

What Happens After an Error?

Based on the many scenarios listed above, a medication error may lead to:

  • Medical complications
  • Reduced immune response
  • Organ failure
  • Malnutrition
  • Dehydration
  • Ineffective treatment
  • Death

Do you believe your loved one has experienced a medication error while in the care of a nursing facility? As you put your trust in the home to care for and correctly treat your parent, partner or relative, it’s a shock to find that your loved one’s health has been put in danger by professionals you depend on.

Whether the error falls under negligence, malpractice or misdiagnosis, Trantolo & Trantolo can assist with your claim. If you believe you have a case, contact our team today.