Medication Errors Over Medication <Course Name, Course

Medication Errors

Over Medication

Overmedication can be described as an inappropriate medical treatment that occurs when a patient takes unnecessary or excessive medications. This may happen because the prescriber is unaware of other medications the patient is already taking, because of drug interactions with another chemical or target population, because of human error, or because of undiagnosed medical conditions. Sometimes, the extra prescription is intentional (and sometimes illegal), as in the case of the use of excessive psychoactive medications as "chemical restraints" for elderly patients in nursing homes. The purpose of the research paper is to identify the root causes of overmedication and its effect on healthcare. It then goes on to identify the role that a nurse can play in elimination medication errors.

Root causes of Overmedication:

Overmedication is the misuse or prescription of medication in situations where less medication would be more beneficial to the patient. Patients are being vastly overmedicated for often relatively minor mental health concerns. This over-reliance on quick-fix medication is numbing the nation and dulling awareness of real and pressing social issues and of non-psychopharmacological therapies and treatments.

Overmedication is not a mechanical problem that can be easily corrected by new guidelines or procedures alone. It is a chronic problem which exists within both a cultural and economic framework. The cultural framework for overmedication is that people often want a "quick fix." The economic cause of overmedication is that prescription drugs generate huge profits, whereas most non-drug approaches (such as diet, exercise, rest, and some "alternative therapies") either generate no profit or very low ones. The profit motive introduces a huge incentive for the pharmaceutical industry to shape the culture surrounding medicine as much as possible, mainly through advertising.

Doctors and other healthcare professionals are inundated with promotional materials for various prescription medications. Even when doctors think they are doing a good job of sorting through or filtering out this material, the fact is that they are exposed to a lot of material about the latest prescription medications, whereas they are exposed to much less about nutrition, movement-based therapies, herbal therapies, lifestyle-change treatments, or alternative therapies.

Another important instance of overmedication occurs when consumers are prescribed OTC drugs which produce the same or similar therapeutic effects. For example, overmedication can occur when a prescription drug like "Vicodin," which contains both "hydrocodone" and acetaminophen, is taken along with the nonprescription product Tylenol, which contains acetaminophen as the active ingredient. As a result, medications may accumulate at higher levels, causing undesired side effects, sometimes serious, even fatal (Deene, 2009).

Patients also become part of the problem to the degree to which they become sucked into the culture that looks to drugs for the answers. Patients can often pressure their doctor to prescribe something, which can result in a doctor reluctantly prescribing a medication when in reality they may be leaning against the choice of prescribing drugs.

Impact on healthcare:

The use of multiple, often unnecessary medications especially among older people is an entrenched, escalating, frightening, and mostly unexamined problem in modern health care. Although medications can ease many conditions, multiple-drug use often exacerbates existing ailments and causes troubling side effects that are treated with yet more drugs. Symptoms of overmedication occur gradually. Often, they are chalked up to "growing older." Fatigue, confusion, dizziness, weakness, memory loss, loss of balance, impotence, constipation, slowed reaction: speech, movement and thought, sleeplessness, unsteady gait, uncontrollable repetitive movement of the tongue, feet, hands and hallucinations are only a few side effects of overmedication. Perhaps one of the most insidious aspects of overmedication is its effect on cognition and the mental capacity of seniors (Siri, 2008).

Falls are a major negative effect of overmedication. Thirty percent of people 65 years and older fall each year. Falls account for ten percent of all visits to the emergency department, and one out of ten results in a serious injury. The following have been associated with an increased risk of falls: arthritis, depressive symptoms, orthostatic, environment factors, cognitive impairment, impaired vision, balance disturbances, gait disturbances, decreased muscle strength, and use of four or more medications (Barber, 2008).

Role of a nurse in elimination of medication errors:

The nurse literally plays the role of a lifeguard in medication administration. S/he often provides the last opportunity for the health-care team to identify and correct errors in prescribing and distributing medication. Although the physician prescribes the medication and the pharmacist fills the prescription, the nurse usually administers the medication. S/he is the last link in medication administration and a safeguard against error.

Prior to administering medication the nurse should verify the patient's identity. The "Journal of Continuing Education in Nursing" reports that "patient misidentification continues to be the root cause of many errors." To prevent errors, the nurse should use two sources of identification and check for matching information. The nurse should compare the patient's wristband identification with a written document such as a MAR or physician's order. Alternately, the nurse may ask the patient to state his name and birth date and match the information to the patient's wristband.

In safely treating the patient, the nurse should observe six patient rights by ensuring that the right medication is administered, in the right dosage, to the right patient, at the right time, via the right route, in accordance with the physician's orders. The process should be completed with the right documentation. In addition, before a nurse administers medication, she should be aware of the expected effect of the drug. A nurse should then monitor the patient and report any adverse reactions to the medication.