SAFE MEDICATION USE

1. The 3 R's for Safe Medication Use: Medications have RISKS as well as benefits; weigh them carefully for each medication you take; RESPECT the power of your medications; and Take RESPONSIBILITY for learning about how to take your medication safely.

2. Keep an up-to-date list of all your medications with you.

3. Learn the name of each medication, what it's for, what side effects to watch for, what you should do about them, and possible interactions with other medications you are taking.

4. Ask questions about how to use the medication. Make sure you understand the directions. If you are told to take a medicine three times a day, does that mean eight hours apart exactly or at mealtimes? Should the medicine be stored at room temperature or in the refrigerator? Are there any medications, beverages, or foods you should avoid?

5. Read and re-read medicine labels before you take or give a medication to avoid mistakes. In the middle of the night, you could mistake ear drops for eye drops, or accidentally give your older child's medication to the baby if you're not careful.

6. If possible, get all your prescriptions filled at the same pharmacy so that all of your records are in one place. You can ask your doctor to write the purpose on the prescription as a cross-check in case there is some confusion.

7. Be cautious when refilling prescriptions to make sure you are getting the right medication.

8. Protect your family. Know what you and your family members are taking: what is the medication; when, how and how long to use it; when to expect results; and, when to contact your doctor or pharmacist.

9. Use the measuring device that comes with the medication, not spoons from the kitchen drawer.

10. If you take multiple medications and have trouble keeping them straight, ask your doctor or pharmacist about compliance aids, such as containers with sections for daily doses. Family members can help by reminding you to take your medicine.

A MEDICATION ERROR STORY...

When Jacquelyn Ley shattered her elbow on the soccer field two years ago, her parents set out to find her the best care in Minneapolis. "We drove past five other hospitals to get to the one we wanted," says Carol Ley, M.D., an occupational health physician. Her husband, an orthopedic surgeon, made sure Jacquelyn got the right surgeon. After a successful three-hour surgery to repair the broken bones, Jacquelyn, who was 9 at the time, received the pain medicine morphine through a pump and was hooked up to a heart monitor, breathing monitor, and blood oxygen monitor. Her recovery was going so well that doctors decided to turn off the morphine pump and to forgo regular checks of her vital signs.

Carol Ley slept in her daughter's hospital room that night. When she woke up in the middle of the night and checked on her, Jacquelyn was barely breathing. "I called her name, but she wouldn't respond," she says. "I shook her and called for help." The morphine pump hadn't been shut down, but had accidentally been turned up high. The narcotic flooded Jacquelyn's body. She survived the overdose, but it was a close call. "If three more hours had gone by, I don't think Jacquelyn would have survived," Ley says. "Fortunately, I woke up."

Ley was pleased with the way the hospital handled the error. "They came right out and said the morphine pump was incorrectly programmed, they told me the steps they were going to take to make sure Jacquelyn was OK, and they also told me what they were going to do to make sure this kind of mistake won't happen again. And that's very important to me." The hospital began using pumps that are easier to use and revamped nurse's training. Ley believes there were many contributors to the error, including the fact that it was Labor Day weekend and there were staff shortages. "It goes to show that this can happen to anyone, anywhere," says Ley, who now chairs the board of the National Patient Safety Foundation.