Sandy Berreth, RN, MS, CASC, administrator of Brainerd Lakes Surgery Center in Baxter, Minn., and a AAAHC surveyor, shares the following thoughts on three critical areas of focus for safe drug management in an ASC.
1. There are a few medication standards that have caused some concerns at the time of a CMS or AAAHC survey. One of these standards calls for a facility's review and update of all individual patient medications at each visit, including over-the-counter products and dietary supplements. Facilities should have a method of tracking their patients use of such products; this is especially important for some supplements that can affect surgical outcomes and patient safety, such as increased bleeding concerns, cardiovascular concerns and drug interactions, including detrimental effects on the anesthetic agents. It is helpful to have an individual section in your medical records dealing with herbal supplements and over-the-counter products. The preoperative phone personnel should identify potential concerns. It would be suggested to have a list of the more common over-the-counter products and dietary supplements and their effects located where the preoperative phone calls are made.
2. CMS is emphasizing the labeling of all injectable medications that have been drawn into syringes and oral medications that have been removed from the original packaging. These medications must be identified by the original manufacturer and be appropriately labeled with the initials of the person who draws it and the label should include the date and time to indicate when it was drawn, as well as both content and expiration date (CMS standard 416.48(a)). It is a common practice for facilities to have templates for labels that the staff uses when drawing these medications up.
3. Finally, if sound-alike or look-alike medications are present, the organization identifies and maintains a current list of these medications and has policies in place to prevent errors. There are online resources to help an organization identify all the possible look-alike or sound alike medications, include the list in the policy and procedure book and hang it when the medications are stored for a quick review.
Read more about medication management:
- 4 Points on Medication Management for Back Pain
- 20 Questions Surgery Centers Should Ask to Ensure an Effective Safe Medication Management Program
- Safe Injection Practices Checklist: 12 Critical Rules to Follow