Medication safety in homecare is one of the biggest patient safety concerns in the UAE. Medication errors at home are among the highest risks patients face. Recent admission data at Enayati Home Healthcare shows that around 50% of hospital discharges contain some form of medication discrepancy, as defined by the Institute for Safe Medication Practices (ISMP Canada).
Incomplete Information
The prescribing physician is often unaware of treatments and medicines prescribed by other doctors. On the final day of a hospital stay, discharge orders are often left to the house officer on duty.
In some cases, families set aside the advice of the medical team that has just treated a major stroke and instead follow their long-standing cardiologist at another private hospital. We have seen patients discharged home on one blood thinner while the family insisted on continuing a different blood thinner that had been prescribed earlier.
In these situations, our nursing team carefully gathers information from every member of the care team to build an accurate picture of the patient’s medications.
Not Enough Time at Discharge
Hospital discharges are often rushed. Families are given a tentative discharge date and time, but everything depends on the results of the morning blood test. The ward doctor reviews the results with the consultant to get final discharge clearance.
Once cleared, the family often has about two hours to vacate the room, settle the bill, and wait for medicines from the pharmacy. Very little time is spent reviewing the medications. Even when they are reviewed, families remember little of it because of the anxiety of going home.
Medication Reconciliation at the Hospital
Reconciling medications before the patient leaves hospital gives everyone the chance to clarify questions with the hospital team while they are still available. Common discrepancies include:
- Differences between the physician’s order and the pharmacy’s instructions
- Differences between the physician’s order and the verbal instructions given by the nurse
- Missing instructions for medicines the patient was taking before the hospital admission
On request, our homecare nurses will visit the hospital on discharge day as part of the admission process, at no extra cost. Spending one hour at the hospital can save many hours of chasing clarification after hours.
Understanding the Family’s Knowledge
A key part of medication reconciliation is asking the family, “Why are you taking this medication?” Families know the patient’s health history in depth. How they understand each medicine often reveals gaps or discrepancies that need clarification.
Sometimes all it takes is one phone call or one visit to the doctor. The homecare nurse gathers the information and works to resolve discrepancies within the first 24 hours.
Our team also speaks with the family’s drivers, cooks, and other domestic staff, who often see the medication routine every day. One simple technique is to take the clock off the wall and ask the family cook to point to the time the medicine is usually given.
Medication Safety Challenges in Homecare
Medication safety at home is a high-priority programme at Enayati. All hospitals urgently need to follow a standard discharge medication procedure, to reduce variation between settings.
Patients returning from treatment abroad often bring a different medication regimen, which families insist on following. Reconciling these medicines is difficult and falls outside normal medication safety guidelines. Identifying discrepancies, including drug-drug interactions, requires a systematic, programme-based approach.
Our Commitment to Medication Safety
Enayati Home Healthcare follows the Institute for Safe Medication Practices (ISMP Canada) guidelines for medication safety. Our accreditation to Canadian standards requires a thorough review of every patient’s medications at hospital discharge and on admission to our homecare service.
