ISMP

Novolin/Novolog…Ephedrine/Epinephrine…Zyprexa/Zyrtec

How often do you read something and assume a word is something else?

            This may not happen to you, but it happens to me all of the time!  For example, on many tests, I will read correct instead of incorrect.  Doing this really upsets me because I miss the answer unless I notice it when I go through the test a second time.  I now try to CIRCLE those words that I easily misread when I catch them so I know to look back and see if what I read was correct.

            In the pharmacy, everyday is a test. If you and/or I fail to recognize something as minute as a one or two letter word differences, it could mean the end in a patients life.  Since so many medication names sound and/or look alike, it is beyond easy to grab the wrong one (especially when working at a fast paced).  Sadly, mistakes like this happen all the time and it then becomes the pharmacist job to do that double checking. 

The Institute for Safe Medication Practice (ISMP) tries to enable a safer practice environment for pharmacies.  One of the things they try to implement is proper labeling of medications of the look/sound-alike medications by using TALL man lettering (aka capital letters where the names differ).  Although there are tons of people who are lucky enough to rarely misread information, for the ones who are (like myself), these guidelines make working in the pharmacy so much safer.  It is up to pharmacy to implement the use of those labels that follow the guidelines.  This was my job yesterday.  I was in charge of changing all of the labels that stored oral medication to have matching labels that were easy to read based on ISMP guidelines. 

After a half an hour of typing the labels based off the old ones, I realized there were a lot of spelling errors and brand/generic name was missing.  For some of these medications that I already typed, I started pulling the bottles out of the bins to find the correct information (which not all of them had).  All of the sudden ‘POOF’ I had an epiphany.  I reached into my white coat and pulled out my iPod.  I started plugging in different medications in Epocrates and getting all of the answers I wanted.  (I could view all the brand/generic names, doses, use etc.) With the help of ISMP and Epocrates, I was able to contribute to the safe medical distribution of HIPPE.  Currently, my iPod has come in use for fun, home work, pharmacy knowledge, and now making a safer environment for patients.  It’s crazy to think that a tool that can do all of this fits right into my pocket.  Today’s use of technology in medication will save tomorrow’s patient.