In the last post I asked if “engaged patients” was a buzz-word or a reality given the differing ways people interpret the term engaged. If we believe that “engaging patients” means to actively listen to understand the patient’s needs, we are on a path to partnership with patients and families. Active listening opens the door to meaningful two-way communication. The added bonus of tuning-in for a couple of minutes is that patients sense a higher level of interest from the nurse and doctor. And this is your direct connection to managing HACAPS.
HACAPS will never be a true measure of clinical care but it is here to stay. This means we need to be creative, share those ideas, and accelerate the use of successful strategies to foster effective communication, “engagement”, with patients. Let’s look at a strategy busy clinicians can use to support the patient’s perception of their care as well as foster their role as partners in safe care.
A medication error is something we all want to avoid! If it has happened to you, the scar sits in your psyche as a reminder you are human and therefore likely to make a mistake. This is why well-designed systematic processes are so essential in hospitals. But we have farther to travel to achieve high reliability. There are 400,000 preventable medication errors in our hospitals every year, and sadly patients often say, “I didn’t think I was supposed to have that medicine”.
Let’s bring the patient and family member into the conversation about medication safety by using some of the evidence. Many of you may already be doing these three things:
1. Cross-checks on medications
Just like aircrews, cross-checks (medication reconciliation in our lingo) are essential safety checks. Only here we ask, should expect, our patients to be involved by bringing their list from home. If the patient is unable, then a family member can fill this role on admission and when the patient is transferred between units.
2. Give the patient, or family member, the medication list.
They should have a print out of the medication and be told why it is ordered and how to monitor the person’s response to the medication.
3. Old-fashioned 5 Rights fits most patients
We know we cannot rely on this long standing pneumonic to assure safe medication practice but we can certainly let patients and their family member know they should engage in the medication dance by asking these questions:
- Is this the Right medication for me?
- Is this the Right dose and preparation for me?
- Am I the Right patient?
- Is this the Right time?
- Is this the Right route?
If patients and families are handed a medication print out and an “engaging” info sheet giving them permission to ask questions about their medication do you think this type of partnering can have a big impact on reducing errors?
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