Aim This study aims to assess the need to formalize medication monitoring strategies in electronic records in two crisis resolution home treatment (CRHT) teams in one UK NHS Trust. Background The management and monitoring of prescribed medications has long been a cause for concern. As a result of the potential adverse drug reactions associated with commonly prescribed medication, clients of mental health teams are vulnerable to iatrogenic risk linked to physical health problems. Method Electronic records for all clients receiving care in two CHRT teams in one UK mental health Trust in November 2007 were examined for evidence of monitoring for potential adverse drug reactions. Findings were compared with the sample of paper records submitted to a national audit. Results Electronic records omitted important aspects of medication monitoring, for example: 14 out of 57 clients had blood pressure recorded; 15 out of 57 had heart rate recorded; 13 out of 57 had weight recorded. However, the teams’ paper records were significantly better than both the electronic records and a national audit sample at recording blood pressure and obesity. We found few differences between our two teams. Conclusions The format of our electronic records requires modification to ensure that systems are in place to document adverse drug reactions and the physical health of those with mental illness. Implications for nursing management The transition to electronic records needs to be carefully managed to ensure that information on adverse drug reactions is included. The West Wales Adverse Drug Reaction profile, version II, is one strategy to achieve this in mental health.
Every day, clinical adverse events occur within our health care system, causing physical and psychological harm to one or more patients, their families, staff (including medical staff), the community, and the organization. In the crisis that often emerges, what differentiates organizations, positively or negatively, is their culture of safety, the role of the board of trustees and executive leadership, advanced planning for such an event, the balanced prioritization of the needs of the patient and family, staff, and organization, and how actions immediately and over time bring empathy, support, resolution, learning, and improvement. The risks of not responding to these adverse events in a timely and effective manner are significant, and include loss of trust, absence of healing, no learning and improvement, the sending of mixed messages about what is really important to the organization, increased likelihood of regulatory action or lawsuits, and challenges by the media.