Drug Compliance

Introduction

Medication and drug compliance relates to the patient following the directions of the healthcare team. If a patient isn't complying with the directives of the medical team, the communication must be assessed to ensure the patient is educated on his or her medical needs. Quality assurance and the Seven Rights of Medication Administration help the healthcare team maintain high standards when dispensing drugs and medications.

 

Medication Compliance and Quality Assurance

In the healthcare field, compliance refers to the degree to which a patient follows the directions of his or her healthcare providers. There are many reasons for medication noncompliance. For example, a patient may not understand the instructions, the medication may be too expensive, or side effects may be creating problems for the patient. Eliminating some or all of these reasons can be helpful in increasing compliance.

Written and verbal instructions should be provided to patients. If possible, instructions should be given to both the patient and a family member or caregiver who is with the patient at the time of the office visit.

*Barriers to communication need to be assessed and evaluated before instructing the patient. Language barriers, hearing and vision deficiencies, and differing cultures and religions can cause confusion in giving directions and can lead to noncompliance. Accurate communication is vital for medication compliance.

 

Quality assurance is all about establishing high standards in patient care and developing professional practices towards those standards.

You'll find quality assurance included in the policies and procedures in each medical office and medical facility. The goal of quality assurance is that the policies and procedures provide the patient with a high-quality standard of care.

When the policies or procedures aren't followed, the potential for errors in the delivery of patient care increases.

Safety with medications, whether over-the-counter medicines or prescriptions, is an important factor in providing good patient care. Healthcare professionals have the responsibility to obtain a list of all medications that a patient is currently taking. This includes prescription, herbal, over-the-counter medications (OTC).

 

Here are some important points to remember when you're discussing OTC medications with patients:

Caution. OTC drugs must be taken with the same caution as prescription medications.

The patient should be taught to read all of the instructions on the OTC label.

Safe Dose. The safe dose for a 24-hour period, which is noted on OTC labels, shouldn't be exceeded.

Interactions. All OTC medications should be evaluated to make sure that an adverse drug-to-drug interaction won't occur.

Allergies. Allergies are an important consideration in choosing OTC medications. OTC medications can have changes in their inert ingredients between batches of the same brand or between various brands and manufacturers. Encourage patients to read labels carefully before they buy any OTC drug to verify that allergens aren't listed in the ingredients and interactions won't occur. 

Home Use. Using over-the-counter medications at home for a condition can cause a patient to delay seeking medical care.

Dosages. Patients should know that OTC dosages of medications are low and may not be therapeutic, depending on the patent's condition. An example is Aleve, an OTC brand of naproxen that's taken for chronic pain. Aleve comes in 200-mg tablets, only one or two of which should be taken daily. Yet naproxen also can be prescribed by a medical professional in dosages of 375 to 500 mg, two to three times a day.

 

Medication Standards and Administration

Many people think that pharmacology is the administering of medications. However, pharmacology is really the knowledge necessary to safely administer medications. The term medication administration means giving a dose of medication to a person. In most cases, a patient self-administers.

There are three primary healthcare professionals directly involved with medication administration:

• Physician
• Pharmacist
• Allied health professional

 

We know that blood and body fluids can contain microorganisms that are capable of causing disease. In July 1992, the Occupational Safety & Health Administration (OSHA) began to require and enforce safety precautions for bloodborne pathogens.

OSHA requires that every medical facility have a workplace exposure plan. Here are some OSHA standards specific to administering medication:

Barrier equipment should be worn if there's a chance of body fluids splashing or spraying during administration of medications.

Healthcare providers should wear gloves when performing injections.

Disposable equipment and needles that have come in contact with body fluids must be properly disposed of in puncture-proof containers.

All syringes and needles should have a safety system, such as a retractable cap. A puncture-proof biohazard container should be in close proximity to the area of use. If a needle does need to be recapped, then the "scoop" method should be used.

Contaminated waste must be disposed of according to local, state, and federal regulations.

All exposures to body fluids must be evaluated. Then, a post-exposure follow-up plan, including an incident report and medical evaluation, should be completed.

 

Seven Rights of Medication Administration

Even though you won't be responsible for administering medications, the healthcare professionals that you'll be working with in your new career may be responsible for the ordering and administering of medications. There are seven vital steps that all healthcare professionals follow when preparing to administer medications.

Healthcare professionals who follow these "seven rights" are applying their knowledge to administer drugs safely.

Right Patient

The healthcare professional must verify that he or she has the correct patient.

Right Drug

The healthcare professional must make sure to verify that he or she has the correct drug. Many drugs may look alike, and their spelling and pronunciation may also be similar.

Right Dose

The healthcare professional must verify the dose that was ordered is the dose that he or she is preparing to administer.

Right Time

The healthcare professional must verify with the order that it's the right time. Medications like vaccines have certain spacing requirements. Giving a vaccine too early can render it ineffective, and the patient would need to be reimmunized at a later date.

Right Route

The healthcare professional must double-check the order and verify the correct route (example: intramuscular injection or subcutaneous injection).

Right Technique

The healthcare professional must select an appropriate site and use the correct administration techniques for administering the medications (example: identifying the correct anatomical site and using the correct technique for an intramuscular injection).

Right Documentation

The healthcare professional must document in the patient's record immediately after administering the medication.

 

Key Points

• Compliance refers to the degree to which a patient follows the directions of his or her healthcare providers.
• Some problems leading to noncompliance include the patient not understanding the instructions, the cost of the medication, or side effects that create problems for the patient.
• Written and verbal instructions should be given to the patient and a family member or caregiver.
• Barriers to communication must be assessed and resolved in order to provide accurate communication.
• Quality assurance establishes high standards in patient care and develops professional practices towards those standards.
• The goal of quality assurance is that the policies and procedures provide the patient with a high-quality standard of care.
• Medication administration means giving a dose of medication to a person; most typically, this is done by a physician, pharmacist, or allied health professional.
• The Occupational Health & Safety Administration (OSHA) requires and enforces safety precautions for bloodborne pathogens. OSHA requires that all medical facilities have a workplace exposure plan.
• The seven vital steps, or Seven Rights, that all healthcare professionals follow when preparing to administer medications are: right patient, right drug, right dose, right time, right route, right technique, and right documentation.