Lifting a Regulatory Burden Could Create Dangerous Consequences
As someone who has visited family members and others in the hospital, I also can envision the problems relaxing this rule could present. A son, a daughter, and a wife all know about Tom Smith's need for a certain daily pill. And when they all visit him in the hospital, they all make sure he gets it. But they all visit him at different times. Then the nurse comes to administer it again.
Mr. Smith might object, but hospitalized patients often get confused over the shock of their new surroundings, even if they otherwise would have the capability of remembering what their dosage should be.
And in any case, physicians evaluating his care may ultimately discover those medications might be the very ones causing some of his medical problem, or are contraindicated.
Richard Bankowitz, MD, chief medical officer for the quality and purchasing healthcare network Premier Healthcare Alliance, sees both sides.
On one hand, he says, the rule "is "meant to balance the fact that as patients are admitted to the hospital, many of them are on chronic medications that need to be taken at a certain schedule," he tells me in an interview. "There's been some concern that as soon as patients come into the hospital their medications get taken away and then they've got to wait for the orders to be written and the medications to come up from the pharmacy. ... It could be very frustrating."
Providing better medication continuity would be a good thing, he says.
On the other hand, allowing patients to keep and administer their own medications comes with some risk, he acknowledges. "The flip side is that there's a documentation issue, so even if it's just one family member, what happens then if the nurse comes by with the medication, and it's not documented in the chart because the family hasn't accessed the medication record and recorded that the medication was given?"
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