Nursing Home Abuse in California: Medication Errors
According to the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP), a medication error is defined as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer.”
Common medication errors include incorrect dosages, mistimed administration, and providing the wrong medication entirely. Errors can occur at any point during the chain of treatment, from prescription and dispensation to administration and monitoring.
Unfortunately, despite strict regulations governing the administration and monitoring of medications in California, errors happen all too often. For nursing home residents who depend on a careful balance of medications to maintain their quality of life and health, the consequences of errors can be severe, leading to adverse drug reactions, worsening of medical conditions, hospitalizations, and even death.
Medication Standards in Nursing Homes
All nursing facilities that prescribe medications to residents should have clear safety standards for training staff and running the facility. These standards should include requirements to:
- Inform family members of any new medications prescribed
- Keep track of each resident’s prescriptions
- Maintain a comprehensive understanding of the resident’s medical history
- Establish and follow error reporting guidelines
- Properly administer and monitor medications
These standards must require facilities to put safety first, and do everything they can to keep residents safe. Nursing homes that fail to adhere to safety guidelines around medication can face legal consequences.
Common Medication Errors in Nursing Homes
Common medication errors in nursing homes include:
- Failure to provide medication on time or at the correct rate
- Providing incorrect dosage
- Providing medications without checking side effects
- Improper medication preparation
- Skipping doses
- Improper administration of IVs
- Failure to inform family members of new medications
- Mixing up multiple patients’ medications
- Failure to provide antibiotics when required (eg for bedsores)
- Failure to monitor patients to ensure correct ingestion of medications
- Improper documentation of medication
- Following incorrect med pass routine
- Providing too much or too little medication
- Lab errors
- Providing expired medication
Errors such as these can put nursing home residents at risk of complications that may result in serious, harmful consequences. For example, over-medicated or incorrectly-medicated residents may suffer unexpected side effects such as dizziness that can increase the likelihood and severity of a fall.
Factors Contributing to Medication Errors in Nursing Homes
Understaffing. Chronic understaffing and high turnover rates in nursing homes often result in overworked staff, which increases the likelihood and severity of mistakes. Inadequate training and reliance on unlicensed assistive personnel for medication administration can further exacerbate the problem.
Lack of Proper Documentation. Inaccurate or incomplete documentation of medication orders, allergies, and resident responses can lead to errors. Electronic Health Records (EHR) systems, while helpful, can also contribute to errors if not properly managed or if staff are not adequately trained.
Inadequate Monitoring and Oversight. Nursing homes may lack sufficient oversight mechanisms to catch and correct errors promptly. Regulatory inspections may not be frequent or thorough enough to identify and mitigate risks effectively.
California Nursing Home Medication Regulations
Skilled nursing facilities (SNFs) in California are licensed by the California Department of Public Health. They are subject to federal and state standards of care. Many are also subject to Medi-Cal and Medicare standards related to medication administration.
The pharmaceutical regulations nursing facilities are required to adhere to as per Title 22 include:
- Maintaining accurate records of medication, strength, quantity, date ordered and received
- Acquiring medication in a prompt and timely manner
- Reporting any irregularities to the patient’s doctor
- Furnishing emergency medical care when necessary
- Ensuring medication is only administered to the patient to whom it is prescribed
See Article 3 for the full list of services required of California SNFs. Additionally, under Title 42, medication error rates in nursing homes must be kept at or below 5%.
Medication errors in California nursing homes remain a critical issue for regulators, healthcare providers, and policymakers. Addressing the root causes through improved staffing, better use of technology, and enhanced training can help reduce errors and improve the quality of care for our most vulnerable citizens.
If your loved one has experienced a medication error in a California nursing home, the first step is to inform their primary care doctor, or call 911 if it’s an emergency. Your local Long Term Care Ombudsman can advocate on behalf of the resident and lodge complaints through official channels.
The next step is to consult a nursing home abuse attorney. At Dudensing Law, we have the expertise, experience, and dedication to take on the perpetrators of elder abuse in nursing homes and assisted living facilities. To speak to a nursing home abuse lawyer in Los Angeles, San Francisco/Bay Area, or Sacramento, contact us here.
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