MEDICATION & RESEARCH
https://www.cqc.org.uk/news/stories/state-care-201718-published https://www.ageuk.org.uk/latest-news/articles/2018/july/1.4-million-older-people-arent-getting-the-care-and-support-they-need--a-staggering-increase-of-almost-20-in-just-two-years/
Remedy the Errors
Steve Sawyer, Director at Access Health and Social Care, explains how technology is enabling care providers to improve efficiencies in medication management and follow procedure to ensure compliance and service-user safety.
The Care Quality Commission’s (CQC) State of Care 2017/18 report highlighted the increasing demands on care providers, with Age UK estimates suggesting that 1.4 million older people do not have access to the care and support that they need. With an ageing population and added pressure on NHS budgets, the demand for care services is likely to continue to rise.
Providing care to people of all ages, both in their own home and in a residential setting, presents a number of complex challenges and considerations; with medication management among the most significant.
Understandably, the CQC places particular scrutiny on the issue during inspections, so it is surprising that so many providers are placed into special measures for inadequate administration of medication.
The major challenge facing both residential and domiciliary care providers in the effective administration of medication is the continued widespread use of paper Medication Administration Record (MAR) charts.
Paper records are a regular source of frustration and anxiety for managers and back office staff, who are trying to ensure accurate and legible records are maintained. This is exacerbated by time-constrained carers being forced to scribble down notes and cram information into small boxes. More important than consistent records, a major worry is that stretched care workers forget to record all of the relevant information on the MAR chart at all.
We are seeing more care providers adopt digital Electronic Medication Administration Record (eMAR) systems to enable an accurate, consistent and compliant medication record. These digital solutions are available on smartphones and link to MAR charts directly, so all information is updated automatically, including detailed notes, meaning that any gaps in medication records are avoided. This information is particularly useful for care homes to gain a real-time update on stock inventory, ensuring that vital medicines are at hand when they’re most needed.
When using paper charts, infrequent courses of antibiotics, for example, can cause issues if records are not updated
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accurately. As care workers are prompted to log their actions, back office staff can track any medication that is missed and any errors can be investigated more easily.
Given the challenges of working remotely, gaps in communication between medication prescribers, care workers and staff in the back office is a problem which particularly affects domiciliary and community care services. Not only does this impact on patient safety, but also on administration work and costs.
For example, if a prescription is changed, or a short course of antibiotics is prescribed, in most cases the care provider is responsible for ensuring that paper MAR charts are updated and replaced in the client’s home. If an up-to-date MAR chart is not available to carers when they arrive at the home, they will not be able to give the person the correct medication or dose.
A CQC inspection of Bay Care Domiciliary Care ranked the provider as ‘outstanding’ and specific focus was paid to the use of eMAR. In particular, the electronic system was praised for updating in real time, meaning that changes to people’s medicines were updated quickly as well as allowing for a medicine to be removed from a patient’s records following a course of antibiotics.
By integrating digital technology, domiciliary care providers can also create more efficient scheduling for their staff. Information about the time when a specific medication is needed by individual patients can be used to create adaptable visit schedules that then feed into the daily tasks for each care worker, saving both time and money.
In order to deliver outstanding, sustainable and, most importantly, safe care, more providers need to think beyond traditional medication management and integrate digital systems into their daily practices. The challenges of stretched budgets and staff will not go away, so the most effective method to ensure a high-performing and compliant medication process will be focused on effective strategy, encompassing security, training, learning and development, up-to-date records and continued assessment.
www.theaccessgroup.com/care-management
www.tomorrowscare.co.uk
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