3 really great ways to reduce medication errors among discharged patients.

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A middle-aged man with Asthma and hypertension was experiencing breathlessness and was rushed to the Emergency department.

He was given oxygen and nebulization. Then after he became calm, he informed us that;  when he began to experience the asthmatic attack, he couldn’t identify his asthma medications from his anti-hypertensive drugs.  

Another female patient in her 50s was admitted at the ED with hypoglycemia.  She had both hypertension and diabetes but could not differentiate between her drugs. She complained that she didn’t know which of her medications was for the hypertension or the diabetes.

 

Why this is a Problem ?

1. There are several patients in Ghana who share the same plight as the two patients. Patients who suffer more than one chronic conditions like; Diabetes and hypertension,  chronic kidney disease and hypertension, HIV and tuberculosis, etc are given more medications. These medications perform different functions and treat both medical conditions separately. But most of our patients are ignorant of the various medications and what they do. Because of this, patients tend to have emergencies due to their inability to differentiate one drug from the other in terms of their conditions. 

Patients are therefore not able to control their medication intake when their levels are either high or low;  example is when a diabetic has low Random blood sugar (RBS)  level but takes her anti-be tic drugs anyway because she doesn’t know which of her medications is for diabetes.

2. More chronic disease patients experience a worsening of their conditions which results in an increase in hospital admissions,  early re-admissions, prolonged hospital stay and increased healthcare cost. All these factors affect the Sustainable  Development  Goals and prevents Ghana from achieving her goal.

What can be done? 

1. Colour coded medication dispenser: I believe as a country with a high illiteracy rate of 24% (CIA, world fact book), using colour coded medication dispensers to serve drugs in our pharmacies especially during discharge could really help control medication errors at home after patients are discharged.joshua-coleman-623117-unsplash.jpg

 

2. Colour coded plastic bags:Plastic-Bals.png

Photo credit: 3JS Brand

Even though the use of  plastic bags is not favourable to the environment, it’s use i’s not currently banned in Ghana. Most hospital pharmacies /dispensaries use plastic bags to package medications for patients.

With these colour coded bags , patients will be able to easily identify which drugs are for which particular condition. This can greatly reduce the rate at which medication errors occur at home.

3. Education, Education, Education! Our patients mostly walk out of our health facilities with just the dosage of their medications explained to them. If they are lucky* they are informed about when exactly to take their drugs whether before or after meals.

But much more needs to be done. Patients need to know and understand well the following;

a. The name of the drug

b. What it does and what condition it treats.

c. When to take the drug and why it should be taken at those times. This helps patients to appreciate more the need to adhere to the instructions if they know how important it is.

d. When to stop taking it. Example: A diabetic taking blood sugar control medications. The patient needs to understand that if the RBS is low, he/she needs not take the drugs.

e. Side effects of the drugs.

Lets help promote the health of Ghanaians and the world at large.

If you thing this post was helpful, please leave a comment, share with others to make impact and follow my blog for more quality  health education.

Thank you!

Have a great day. …

 

 

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15 Patient’s rights you never knew you had in Ghana.

 

 

The ignorance of most Ghanaian patients is something that lots of stakeholders benefit from with the exception of the patient who bears the disadvantage. From the government heads to the hospital heads, the doctors, nurses, pharmacists, midwives, medical laboratory scientists, and all other working professionals and auxiliaries in our health facilities across the nation. Because the patient doesn’t know their right, they are more often than not given any kind of care. But learning your right as a patient can not only arm you to demand the right care, but also put others on their toes to deliver the best care.

THE PATIENT’S RIGHTS

As a patient;

  1. You have a  right to quality basic health care regardless  of your geographical location ( it is your right, do not let anyone make you feel like they are doing you a favour).
  2. You are entitled to full information on your condition and its management and the possible risks involved except in emergency situations when you are unable to make a decision and the need for treatment is urgent. (As a patient, always ask questions. If the nurses and doctors are not telling you, you have the right to ask. So ask and be informed about your own health. Never leave the hospital not knowing what you are suffering from, what caused it, how to prevent and manage it).
  3. You have the right to know of alternative treatment(s) and other health care providers within the Service if these may contribute to improved outcomes.
  4. You have  the right to know the identity of all your caregivers and other persons who may handle you  including students, trainees and ancillary workers .
  5. You have the right to consent or decline to participate in a proposed research study involving you after a full explanation has been given. The patient may withdraw at any stage of the research project.
  6. If you decline to participate in or withdraw from a research project, you are still entitled to the most effective care available.
  7. As a patient you have the right to privacy during consultation, examination and treatment.
  8. In cases where it is necessary to use the patient or his/her case notes for teaching and conferences, the consent of the patient must be sought.
  9. You are entitled to confidentiality of information obtained about you and such information shall not be disclosed to a third-party without your consent or the person entitled to act on your behalf except where such information is required by law or is in the public interest.
  10. You are entitled to all relevant information regarding policies and regulation of the health facilities that you attended.
  11. Procedures for complaints, disputes and conflict resolution shall be explained to patients or their accredited representatives.
  12. Hospital charges, mode of payments and all forms of anticipated expenditure shall be explained to the patient prior to treatment.
  13. In case of any exemption facilities, they shall be made known to the patient.
  14. As a  patient you are entitled to personal safety and reasonable security of property within the confines of the Institution ( As a patient in a hospital, it is the duty of the hospital to protect you from any kind of harm. If the hospital fails to do so, you have the right to demand for it or in severe cases, take legal action against them).
  15.  You (patient) have the right to a second medical opinion if you so desire. (This means if you are not comfortable, convinced or satisfied with the care and options you are being given by a particular doctor or hospital, you can ask or choose to seek another opinion).

 

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How to prevent infection next time you visit a patient in the hospital. (Protect yourself and your loved one)

At some point in our lives we all visit the hospital whether as a patient or a relative. Whiles in the hospital to see a loved one on admission, people pick all sorts of infections without realising that they do. In this post you will learn how to better protect yourself and prevent infections whiles visiting a patient in the hospital.

1. Never visit a patient whiles sick: When sick, stay home. Especially when your condition is infectious like colds and flu, or when having diarrhoea. When you visit a patient while sick, you expose your loved one to more sicknesses. Also you expose yourself to other infections in the hospital because your immune system is down. Just stay home if you’re sick.

2. Always ask the doctors/nurses before you see the patient: For some medical conditions, visiting the patient might not be a good idea because of the infectious nature of the condition, or the critical nature state of the patient. So always take time to ask the nurses / doctors if it is okay to see your loved one.

3. Never sit on a patient’s bed  the hospital:  Always use the chair provided at the bedside. If there are no chairs, just stand for the few minutes you are there. Sitting on a patient’s bed in the hospital can expose you to a series of infections which you might be taking home with you.

4. Indulge in hand hygiene whiles in the hospital: Hand sanitizer /alcohol hand rub should be used to clean your hand before you enter the ward and when you’re about to leave. This practice will greatly reduce your espouse to infections. If you visit the hospital and you don’t find one, ask.

Rub the alcohol between your palms and your fingers and fingernails for about 30 seconds.

5. Do not leave your stuff  (belongings like handbags, bowls, water bottles, etc.) on the floor of the ward/hospital. This is bad for you, since you might be carrying infections from the floor to your body.

Stay healthy whiles visiting your loved one at the hospital.

Lack of monitoring of private hospitals causing harm to patients’ health in Ghana.

 

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At the emergency department (ED), a patient was rushed into the most critical unit with an RBS (blood sugar) of  2.1mmol/L. Patient was 54 years old male accompanied by his wife. He was unconscious.

Patient arrived at the ED in an ambulance with two staffs from a private hospital. After resuscitating the patient, the accompanying “healthcare professionals” were asked certain questions and this is what we found out;

The patient was brought to their facility with difficulty in breathing. Without assessing the oxygen saturation (SPO2) they decided to refer because there was no oxygen in the hospital. No vital signs were checked (Blood pressure, Random blood sugar, pulse, respiration or temperature) and no other assessment was done on the patient. He was just put in an ambulance and brought to another hospital. Patient became unconscious en route to our facility.

At this point I was both disappointed and shocked to witness such, because the man (patient ) would’ve lost his dear life due to gross carelessness and ignorance on the part of these “health professionals” who were supposed to help him.

Now looking at the two young people (a woman and a man)  that brought the patient I couldn’t help but ask who they were;

The lady said she was a nurse but the gentleman with him answered quietly “I’m not a nurse”. Then I asked so who are you? He now says shyly “I’m a cleaner at the hospital, but I help bring patients from time to time when there is no one.”

“Huh! Herrrrrrh! ” was my reaction because I couldn’t believe my ears were hearing right.

A cleaner in the hospital accompanying an unconscious patient to a referral point. This is someone’s father, his wife was right with then but she wouldn’t know a thing because in Ghana everyone takes advantage of the ignorance of the citizens without reproach. He would’ve been dead and these two wouldn’t know anything.

We now took our time to educate “the nurse” who happens to be an unregistered nurse trained on the job. Taught her on the step by step assessment of patients when they are rushed to the hospital. And first steps in managing hypoglycemia.

This is my plight and plea;

1. Ghana has become so cheap a country and so careless of the lives of its citizens that we give licences to people to operate facilities that cater for the health needs of the people but fail miserably to monitor their operations. Some of these private facilities employ cheap labour in the form of unregistered/unlicensed nurses to cause such harm to patients who need genuine care.

There should be proper monitoring of such facilities to ensure quality care and improved health outcomes.

2. Professional bodies like the Nurses and Midwives Council should be proactive in protecting the name and standard of the profession by ensuring registered and licensed nurses are employed in all hospitals and clinics regardless of their private status.

Ghanaians deserve better than this!

So many lives are lost not due to their medical conditions but from such carelessness and ignorance.

Let’s protect Ghana

Better monitoring of health facilities can save lives.

 

 

 

 

 

 

 

 

 

How to manage dog bite in the hospital: For the health care givers

The hospital /clinic or health center is a place people come to seek medical help to get better from their sickness or ill-health.  But in Ghana, some health service centers are gradually becoming mere scare crows of what they should be. And instead they are rendering services that are causing more harm to the patients.

One of such harms is the management of patients with dog bites. The trend in most Ghanaian hospitals and clinics is the administration of tetanus injections to people after dog bites and sending them home. 

This act has caused the death of many Ghanaians who thought they had received adequate care after visiting the hospital. The patients who are given tetanus injections end up getting Rabies and then they die.

It is sad to know that these persons took the initiative to go seek medical help but due to the “inexcusable ignorance” of some “health professionals” in Ghana, they lose their lives.

“Tetanus does not prevent rabies after a dog bite! “

So here is what should be done after a patient comes with a dog bite. 

  1. Ask when the dog bite happened. 
  2. Where it happened. Most dog bites that are often reported happen outside of the victim’s home. Some happen in the bush, in the farm, in the vicinity where they live or in someone’s house. Knowing where it happened gives you an idea as to the kind of dog that bit the patient if the dog is a stray dog (which is mostly the case) or has an owner. Stray dogs have a high probability of carrying rabies.
  3. What was done after the bite. The right thing to do is to wash the area affected with soap under running water. But if something else was done, the area should still be washed thoroughly at the clinic with povidine iodine.
  4. Give anti-rabies post exposure prophylaxis. This is an injection given after the bite. It may not be available in some health care centers so if you can’t get it in your hospital or clinic, please write it for the patient to buy from a pharmacy or refer them to another hospital higher than your facility.
  5. Ask them to monitor the dog: If a dog with rabies bites a person,  the dog usually dies after a few days. By monitoring the dog, you can know if the dog has rabies or not.

Let’s learn together to save lives.

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Information you should know before leaving the hospital as a patient.

I have come across a number of patients in the form of friends, family, and strangers who visit the hospital when sick to seek care but leave afterwards only to have no idea what, why, and how they are sick. Most people leave the hospital/ doctor’s office knowing nothing about the condition they are in.  It is important to have the following information as a patient before leaving the hospital.

  • The medical condition: There has been countless times I’ve heard people tell me “I don’t know”; after they have been to the hospital and I ask “what did the doctor say your condition is?”. Then the other question follows, “you didn’t ask?” And they mostly reply, “the doctor didn’t tell me”.  As a patient it is your duty to be curious about what is making you unwell. You ask and be told what your condition is. And for the doctors, it is your responsibility to inform your patient about his/her illness. Always know your medical condition before leaving  the hospital.
  • The cause: People get sick due many reasons. Knowing what made you sick is one step ahead of preventing a reoccurrence. Medical conditions are triggered by different factors. You need to know what you are doing or are not doing that is causing you to get sick.
  • The tests /investigations:  Medical tests or investigations help doctors in understanding and  deciding the type of condition you are having and the kind of management or treatment that you should be given. These tests can be expensive and knowing what exactly is being done for you abdominal what you are paying for helps you to also better understand your condition.
  • The medications: As a patient you should know the medications you have been given. It’s just about the name, but also what the medication does and why you are being given that. You should not just take your prescription and purchase the medications without a proper understanding of what and why you need them. Also the side effects of the drug.
  • Your review date: It is not all conditions and all patients who are asked to come for review. But if you are to come for review,  you should know when (date and time).

Let’s change the habit of visiting the hospital and returning home clueless about the what, why and how of our conditions. Be informed about your health.

Be interested, be educated and be on top of tour care.

Going to the hospital? 8 things your doctor expects you to bring.

Being sick and going to the hospital is something that comes with a lot of anxiety for most people especially if you don’t know what to do and what to expect. For the expectations, well you can’t do much about it except hope for the best outcome, but what you can do something about is your preparation before you go.
Here are 8 things to get you ready for your next hospital visit or doctor’s appointment.

  1.  Your Health insurance card:  Never go to the hospital without your Health insurance card. Going to the hospital without an insurance card means you get to pay cash for everything. From the hospital card to medications prescribed by your doctor. Healthcare is expensive and your health insurance card is there to ease up the cost so use it.
  2. Your medical record card : For people visiting the hospital for the first time, you do not need to worry about this card because you haven’t received it yet. But if you have been to the particular hospital before, then carrying your medical record card with you is is a must. This is usually a small card that has your name and the card number on it for to make it easy to retrieve your folder when next you visit.
  3. All your medications: Every medication you are currently taking should be with you when going to see a doctor. This includes the prescribed and the over the counter drugs. Bringing your medications with you not only helps the doctor to better understand your treatment, but helps him know which drugs to continue, discontinue and which drugs to add to your treatment.
  4. Medical test results: Every test result you have should be taken along when going to the hospital. Both old and new test results should be carried along. This is because the doctor you see might not be the one you saw on your previous visit and you would not want him/her to not have all the information on your condition in case the previous doctor failed to put the results down in your folder. Secondly having your tests results will enable continuity of care and avoid repetition of tests.
  5.  List of your Symptoms: If you are experiencing or have experienced some symptoms, it is best to note them down and bring it along to your visit. Writing your symptoms as you experience them helps you to not forget any. Your symptoms might be a reaction to a drug or treatment, or another symptom of a medical condition. you don’t want to forget this.
  6. A family member or a friend: The hospital can be an unpredictable place to visit when sick. You never know what the headache you are having really is  and whether the stomach ache is only because you skipped breakfast. Bringing along someone can be very helpful especially when you have to be admitted or you need other help. You don’t want to be alone in these times, having good company can take away a load of anxiety which is something your doctor will be happy about.
  7. Your list of Questions: You have questions? Now’s the time to ask them. Asking questions about your condition, management and treatment is something every good doctor welcomes from his/her patient. Take notes of all the questions you would like answers to and bring to your next appointment. Get the answers you need from the right person, your doctor.
  8. Bring some money! Last but certainly not the least, you should always carry money with you when going to the hospital. Some people make the mistake of carrying only their insurance card thinking that it will be enough but they most often get disappointed and frustrated. Carry money with you so you don’t have to go back home if the test you need to do is not covered by the insurance or the medication you are prescribed is non-insured.

Follow these simple tips and you will not only be your doctor’s favourite patient but a satisfied one at that.

5 patients you will always meet in the emergency room on weekends.

It’s the weekend not a life-end.

So it’s the weekend, yayy! Happy mood   activated for many especially those who only work on weekdays.  The week might have been rough or smooth, successful or a failure but it’s the end and it’s time to let your hair down and forget your worries. I get it… It’s the relaxing part of the week and you should be excited!

But this excitement has so many a time been expressed in unhealthy ways that has caused a lot of people more harm than good sending them straight to the emergency room. These7 patients who are constantly seen in the emergency room on weekends are the result of unhealthy weekend choices.

1. The drunk  (Alcohol withdrawal syndrome )

This patient is always seen at the emergency room on weekends.  This patient comes in different forms and type from men, women, corporate and otherwise. They drink locally made beverages and foreign spirits. One thing they have in common is their inability to assess and control thier drinking.

Alcohol has it’s effects but a little control keeps it in check. The emergency room will be a little less choked if you exercised some this weekend.

2. The forgetful Diabetic  (Hypoglycaemia /Hypoglycaemia )

Chronic conditions need a lot of attention and consistency to keep your numbers down to a healthy level.  For the diabetic, watching your diet and taking your medications daily is needed to prevent an episode of either hypoglycaemia (a low blood sugar level)  or hyperglycaemia (a high blood sugar level).

But the weekend is filled up for this diabetic; from weddings, to funerals and other engagements which causes them to forget to eat, check their blood sugar or  take their medication leading to hypoglycaemia. And for the other,  the excitement causes them to over eat or eat what they are not supposed to,  leading to hypoglycaemia.

Regardless of which episode,  this  patient is always present in the emergency room on weekends.

But you don’t have to be. It’s just the weekend, take some time to take care of your health.  I promise it will be worth it.

3. The bar fighter ( injuries on the body)

Alcohol intoxication  has a way of playing with the mind and your emotions. This patient normally comes with injuries ranging from a bleeding eyebrow, an amputated ear (one ear cut off ), broken skull, broken ribs from broken bottles and the list goes on.

This patient only comes in one gender and that is males. The reasons are varied but mostly, arguments gone bad. What’s important is the underlying cause : alcohol intoxication.

Most of these patients go home handicapped, scarred, and some do not get to go back home making the weekend their life-end.

Responsibility is a necessary choice especially when you decide to dink alcohol. Leave early to prevent over indulgence.

4. The unknown patient (Knock down)

This particular pattent may or may not have championed the weekend fun, they are often pedestrians who meet drink drivers, or drivers speeding to their destinations or sadly, spare drivers who are just excited to sit behind the wheel of their master’s car.

The weekend although relaxing can also be dangerous if met with such drivers on the road. The unknown patient is brought to the emergency room without a name because they are mostly unconcious and could remain that way for days. Their lives are then left in the hands of whoever brought them to the emergency room be it the driver or a good samaritan.

A greater percentage of this category of patients experience poor health outcomes due to unavailable funds, family, or lacking advocates to fight for them.

You see, the unknown patient could be anyone and it’s all because of careless acts in the name of weekends.

5. The unpopular referral 

This last patient could be the most vulnerable the five to suffer for the weekend sake. The patient referred on a weekend is beva use it’sa weekend is the most popular of the reasons for referrals although not stated on their card. The state of health of the patient and the documented note for referring says it all.

The patient suffers, the family becomes anxious, cost increases and work load at the emergency room doubles all in the name of weekend fun and relaxation.

Just saying, the emergency room will less choked, mistakes largely reduced, care hugely improve, patients greatly satisfied and health in all protected if you just made the weekend a health concious one.

After all it’s just the weekend , not a life-end!

Continue reading 5 patients you will always meet in the emergency room on weekends.