A couple years ago an article came out on NPR.org focusing attention on the high occurrence of overmedication in nursing homes. According to their sources, over 300,000 nursing home patients are routinely given anti-psychotic drugs in an attempt to control aggressive behavior that often accompanies dementias, such as Alzheimer’s, although antipsychotics are normally reserved for patients with severe mental illnesses such as schizophrenia. And It’s illegal to use antipsychotics to “chemically restrain” patients for the convenience of staff.
Who is to blame? And is “blame” the right word?
Anyone in long-term care understands the frustration of caregivers and nurses. And, you may have even witnessed a nurse heading off to the medication cabinets and grabbing an antipsychotic as a quick fix to “chemically restrain” the patient so that he or she can be more easily managed.
Of course it’s illegal. Of course you want to eliminate it. But where to start?
There are two things at work here that studies indicate contribute to chemical restraint.
- Nurse fatigue, burnout and depression, given a very challenging environment.
- Readily available black box drugs; theirs for the taking.
Fortunately, the issue of nurse fatigue is getting more serious attention.
Hospitals are leading the way with innovative programs designed to take nurses out of circulation for brief periods of time to rest and re-charge. A good example is the Cancer Treatment Centers of America who have begun using “renewal rooms” in their facilities. The hope is that others will follow.
Technology is helping to eliminate drug waste and theft.
The ease of access to drugs in skilled nursing facilities, as it relates to theft and waste, is also being addressed. With some help from technology. Fully automated medication management solutions, such as the Talyst InSite® System, are being installed to ensure the accuracy of meds passing, while keeping drugs secure. In a nutshell, here’s what they do:
- Allow direct connection between the pharmacy and the skilled nursing facility.
- Place secure packaging and delivery systems on the premises, which is locked and centrally controlled.
- Dispense the exact dosage, every time, per patient.
- Keep track of dosage count.
- Eliminate potential for waste and theft.
While no system is 100% fool proof, technology keeps getting us closer. And by removing the instances of loose pills lying about in unsecured cabinets, temptation is removed as well.
Long-term care communities are waking up to the serious issues of overmedication and are beginning to implement new policies and programs to reduce nurse and caregiver burn-out, and help make chemical restraint a thing of the past. Hopefully, in the process of doing so, we will have a healthier, more focused community of nurses – who feel supported by systems that recognize the challenges they face every day and actually do something about it.