A Digital Solution to Misplaced Pharmacy Rx Labels
Summary: This article discusses the challenges and risks associated with prescription labeling errors in long-term care (LTC) pharmacies, emphasizing the importance of using comprehensive LTC pharmacy software solutions like FrameworkLTC to improve accuracy, prevent medication discrepancies, and enhance patient safety.
Table of Contents
The perils of misidentification
Delays and procedural complications
Efficient prescription processing with LTC pharmacy software
Imagine losing track of a label. In a vacuum, this is hardly the end of the world — you just have to create a replacement, and generally speaking, modern labeling technologies make this a quick process. But things are not anywhere near that simple when dealing with prescription labels, particularly in a long-term care pharmacy setting.
If your LTC pharmacy is using old-fashioned paper filing and record-keeping processes, a misplaced or incorrect label will take far too long to rectify. And it won't be much easier if you're using a software platform better suited to retail pharmacy operations. But most importantly of all, labeling errors can jeopardize the health of your facility's patients by preventing or delaying the timely and correct administration of medication — and that's a simply unconscionable risk.
As a community pharmacy, you need the assurance that only a comprehensive ltc pharmacy software solution like FrameworkLTC can offer, to best protect accuracy in prescribing for your clients.
A study published in the journal Research in Social and Administrative Pharmacy found that the medication lists for 77.6% of skilled nursing facilities and 76% of LTC pharmacies had at least one discrepancy between what was on a label and what had actually been prescribed by a physician.
Whether these errors arose specifically from labels being misplaced (e.g., attached to the wrong bottle, vial or other package) or were simply misprints, the problem is the same — medications fail to reach their intended recipient or are incorrect when they arrive. Per the study, gastrointestinal and anti-reflux medications were most frequently the subject of this type of error (accounting for 27.7% of the mistakes). However, several high-risk medication categories were also part of this flood of problems, including anticoagulants, antimicrobial drugs, opioid pain medications and hypoglycemics.
Moreover, if a misplaced or incorrect label causes a patient to receive a medication that is not high-risk in a vacuum, it could still be dangerous to that individual: A nursing home patient with a cirrhotic liver or bleeding ulcer could be put in severe pain by something as relatively benign as a high dose of acetaminophen or an NSAID, respectively. (The latter also carry the rare but very serious risk of hepatotoxicity.)
On a far more grave note, as LTC facilities ramp up their COVID-19 vaccinations, it's critical to acknowledge the stakes at play: A misplaced label or other, similar mistake could quite literally be the difference between life and death. Given the increased scrutiny SNFs are under following the death-reporting scandal in New York, the margin for error is zero, and vaccine and medication categorization should be considered just as important as the infection prevention protocols mandated by state governments.
Danger to patients' health should certainly be the most pressing concern related to prescription labeling and processing, but it is hardly the only one. As the study from Social and Administrative Pharmacy revealed, controlled substance prescriptions issued on hard copies can often go missing when patients are transferred from hospitals to LTC facilities or other SNFs. The reasoning behind the use of hard copies isn't particularly relevant — the issue is the problems they cause. If these prescriptions are misplaced, the cumbersome processes necessary to recover them will cause major delays in patient care.
Communication between the various parties involved in LTC admissions — PCPs, hospital administrators and medical personnel, consulting pharmacists and so on — also often becomes strained when prescriptions, their labels, or medications themselves are misplaced or lost. Ultimately this engenders mistrust and frustration that can further impede or otherwise adversely affect patients' medication regimen and well-being.
Virtually no process in LTC pharmacy management can be made 100% foolproof, but it is possible to come extremely close with the right tools. FrameworkLTC, in conjunction with additional SoftWriters solutions and the many third-party platforms with which it interfaces, streamlines the medication order workflow in such a way that the likelihood of labeling, classification and distribution errors drops to almost nil.
The PointClickCare interface is particularly useful in this regard: personnel at the LTC facility use it to enter medication orders, and in turn, FrameworkLTC automatically locates the patient, their medication list and default SIG codes for pharmacy technicians to select. There are far fewer opportunities for mistakes to be made than what you would experience with traditional labeling methods or retail pharmacy software.
Additionally, FrameworkLTC and PointClickCare reduce the chance of errors at the point of admission through real-time communication with your EHR. Every room change or other patient behavior is automatically registered in the system. When cancelations are necessary, the software also seamlessly handles CancelRx messaging. Moreover, your pharmacy can create customized dashboards within Framework that focus on the data you know you need to track most closely.
Communication is key when dealing with prescription orders, and FrameworkLTC helps you keep those lines open with your facility clients at all times. Put the days of time-consuming, costly, and patient-endangering prescription labeling and classification mistakes behind you by making the switch to FrameworkLTC pharmacy software now.