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Background Information:
National Guidelines and
the Joint Commission
Safety and efficacy of HDS use
• Little is currently known about the safety and efficacy
of HDS use in inpatient setting.
• While many HDS are safe, some cause side effects or
interactions with patients’ medications
• Patients often want to use own HDS during
hospitalization (Beal, 1998; Norstrom, 2002).
“Home Supply” HDS use
• This practice of using a “home supply” makes
identification and reconciliation of HDS use extremely
important.
• Due to risks of HDS-drug interactions or special risks
encountered during surgery
–
e.g. interference with hemostasis, interactions with sedatives or
anesthetic agents (Boyer, 2002).
Guidelines for HDS use
• Currently, no universally accepted guideline for
managing patients’ HDS exists.
• However,
– Joint Commission Accreditation of Healthcare
Organization and
– American Health Systems Pharmacists offer standards
and guidelines on the use of HDS in hospitals
• (Kroll, 2004).
Joint Commission Definition of
“Medication”
• In the Joint Commission Comprehensive
Accreditation Manual for Hospitals, a
medication is defined as:
“any prescription medication, sample medication,
herbal remedies, vitamins, nutriceuticals, over the
counter drugs, vaccines, diagnostic and contrast agents,
used on or administered to person to diagnosis, treat,
or prevent disease or other abnormal conditions...”
(JACHO, 2004).
• Therefore, HDS is considered and shall be
treated as any other medication for a patient.
Medication Standards
•
Joint Commission expects health systems to manage HDS
products with the same diligence and care given to any
prescription medication brought into the hospital by patients
and their families.
•
All HDS should be subjected to medical staff review and
approval and governed by institutional policies
– (Walker, 2000).
Medical Reconciliation Act
• Joint Commission's National Patient Safety
Goal #8 - Medical Reconciliation Act
– requires documentation of any patient use of
herbal remedies, vitamins, nutriceuticals, over the
counter drugs, just like any other medication
• This is a standard that applies to all accredited
hospitals in the United States.
Resources to explore…
• Here are some resources for you to explore
regarding this subject:
– Joint Commission’s Enhanced Medication Safety
http://www.jcrinc.com/Enhanced-Medication-Safety/
– Joint Commission’s National Patient Safety Goals
http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/
– Massachusetts Coalition for Prevention of Medical
Errors, Initiatives
http://www.macoalition.org/initiatives.shtml#3
End of Presentation