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This is Canadian Patient Safety Week (CPSW) and chatter on issues relating to patient safety and healthcare leadership are increasingly on the minds of patients and in the media across the country. CPSW, launched by the Canadian Patient Safety Institute (CPSI), is an annual national event aimed at increasing awareness of patient safety issues in Canada.
This year, the theme of CPSW is Ask. Listen. Talk, and promotes the importance of communication between and among patients, clients, consumers and providers.
Truly commiting to a culture of patient safety, and its advancement, of course extends beyond this week.
One fundamental issue is medication use in the elderly. A new article has been published this October. In Managing medications in clinically complex elders: "There's got to be a happy medium"' Steinman and Hanlon use the case of an older patient taking multiple medications to discuss multiple aspects of his medications. They provide an exact approach for how to assess which medications might be changed, reduced or discontinued, and improve medication use.
The article includes a good discussion of the literature and evidence base, which is acknowledged as being scarce at this time, for the sort of structured approach (using clinical pharmacist, geriatrician, or the PCP).
Abstract: Multiple medication use is common in older adults and may ameliorate symptoms, improve and extend quality of life, and occasionally cure disease. Unfortunately, multiple medication use is also a major risk factor for prescribing and adherence problems, adverse drug events, and other adverse health outcomes. Using the case of an older patient taking multiple medications, this article summarizes the evidence-based literature about improving medication use and withdrawing specific drugs and drug classes. It also describes a systematic approach for how health professionals can assess and improve medication regimens to benefit patients and their caregivers and families.
KT+ , by the McMaster Health Knowledge Refinery, posted the abstract with comments from home care nursing: http://plus.mcmaster.ca/KT/NewArticles.aspx?CAPID=25767
Comment 1: A useful article to remind and draw practitioners' attention to the significance of regularly reviewing medications.
Comment 2: For nurses, this article is preaching to the converted. We already know this!
Comment 3: It offers to ward nurses an exact approach for how they can assess and improve medication regimens to benefit patients and their caregivers and families.
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