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Rau J. Kaiser Health News. July 6, 2017.
System failures contribute to recurring problems in health care environments. This news article spotlights how lack of follow-up or action related to inspection reports that have uncovered factors in long-term care facilities that contribute to inadequate care can enable poorly performing nursing homes to remain in operation.
Journal Article > Study
Medication administration errors in assisted living: scope, characteristics, and the importance of staff training.
Zimmerman S, Love K, Sloane PD, Cohen LW, Reed D, Carder PC; Center for Excellence in Assisted Living-University of North Carolina Collaborative. J Am Geriatr Soc. 2011;59:1060-1068.
Medication errors are common in long-term care facilities, and prior research has shown that many of these errors occur at medication administration. This is particularly a problem at assisted living facilities where non-nursing clinical staff (such as medication aides) are often charged with administering medications. Direct observation of medication administration at two assisted living facilities in this study found that the overall error rate was similar between nurses and non-nurses, but less trained staff from either discipline had markedly higher error rates. As the regulations regarding medication administration in assisted living facilities vary from state to state, the authors advocate for more uniform training standards for all staff authorized to administer medications.
Journal Article > Study
Tjia J, Bonner A, Briesacher BA, McGee S, Terrill E, Miller K. J Gen Intern Med. 2009;24:630-635.
Patients transferred from hospitals to skilled nursing facilities (SNFs) are vulnerable to medication errors, as they are often elderly, have multiple chronic illnesses, and take multiple medications. In this study, medication discrepancies (among the hospital discharge summary, SNF referral form, and SNF admission orders) were the rule rather than the exception. Most concerning, many discrepancies involved high-risk medications such as opioid analgesics, anticoagulants, and hypoglycemic agents, which have been linked to serious medication errors in elderly patients. While The Joint Commission has mandated medication reconciliation for long-term care facilities as part of the 2009 National Patient Safety Goals, the authors note that many SNFs do not maintain Joint Commission accreditation, implying that state or national regulations may be needed to improve medication safety across the hospital–SNF transition.