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Written by: comment editing room
2020-09-22 07:30
Last update date: 2020-09-22 07:30
Recently, family members of the elderly were interviewed by the media, reprimanding the elderly homes for being suspected of distributing the wrong medicine to cause brain disease and coma, and complaining about the rat infestation for a long time.
Incidents of distributing the wrong medicine are not uncommon, but the elderly industry has not been able to stop it.
The Social Welfare Department is the supervisor. In the past, it has introduced measures to improve the drug management capabilities of residential care homes and their staff. It seems unsustainable. The Department must look for loopholes to improve drug distribution techniques, strengthen the role of pharmacists, and increase penalties. The elderly and their families regained confidence in elderly services.
It is inferred that taking the wrong medicine causes the disease to worsen
An 84-year-old mother-in-law had her first stroke in 2015. She was admitted to the nursing home in 2016. She had another stroke in May 2019, but she was still in good spirits. At the end of July this year, her health suddenly changed and she was sent to the hospital. Take diabetes medicine that is not prescribed by the hospital.
The family recalled that last year they discovered that the staff had given the wrong medicine. The staff said that they were "nothing" and that they were "rest assured".
The SWD stated that after investigation, it issued a warning letter to the institution regarding the delivery of the wrong medicine. It is reported that the case has entered the prosecution process.
If the family members repeat the response of the staff of the institution and infer that the reason for the deterioration of the condition is true, it means that the institution has been rashly handling the distribution of drugs and the crime is unforgivable.
When the family arranges the elders to live in the homes, they believe that the homes will take care of the family members properly. The staff have always been experienced in handling drugs and should be familiar with them.
In addition, nearly half of the residential institutions involved are government-funded Class A, and the SWD’s inspection regulations should be strict. Unfortunately, mistakes still occur.
Whether the incident of dispensing the wrong medicine is accidental or the tip of the iceberg, the outside world does not have a firm figure, but from the newspaper reports over the years and the active investigation report of the Office of The Ombudsman, the wrong medicines often happen.
More importantly, the government, elderly and pharmacist sectors have introduced measures to try to solve the problem, but they have not been able to stop it.
Most of the elders in the homes need to be taken care of by others, so the task of handling drugs falls on the health workers.
(Information Picture/Photo by Zheng Zifeng)
The government, the elderly, and the pharmacy have countermeasures
In practice, if the institution employs a pharmacist, there will be an extra check for the residents, but this involves a certain amount of salary and the institution may not be able to afford it.
As early as 2010, the government implemented the "Inpatient Pharmacist Service Pilot Program" and entrusted the implementation of the Hong Kong Pharmaceutical Services Fund. Pharmacists evaluate the hospital drug management system and procedures, improve the drug record system, review drugs for residents, and train staff. To reduce the chance of error.
The participating institutions "buy hours" to pay for the service fees of pharmacists' visits, and the government can provide about 70% of the subsidy.
The plan runs until 2018, and only six institutions have participated in the last year and received funding. The Chairman of the Hong Kong Pharmaceutical Services Fund Jiang Xiuzhu pointed out that there are two reasons.
One is that each subsidy lasts only one year, after which the homes have to pay for themselves; the other is that some homes are unwilling to be bound by the reporting work attached to the subsidy scheme and are stigmatized for poor management because the SWD will investigate item by item for poor performance The place has become evidence of insufficient supervision of institutions.
On the other hand, the electronic drug dispensing system developed by companies on the market saves manual copying of medication time, detection of conflicting medications, automated subcontracting of medications, etc., and can record medication data, reducing staff verification tasks and reducing the chance of manual errors.
It has been adopted by social welfare institutions, saying the effect is good.
However, the outside world has no way of knowing how many institutions use electronic drug delivery.
In terms of legislation, the government's punishment for distributing the wrong medicine to the institution is hard to say.
First of all, the Regulations on Homes for the Elderly and the Regulations on Homes for the Elderly do not expressly stipulate that drug incidents are crimes and cannot be directly prosecuted. The SWD can only follow the Code of Practice for Homes for the Elderly to issue exhortations and Warnings or corrective instructions, the SWD can only prosecute or revoke the license if the institution does not change after repeated persuasion.
From observations, Jiang Xiuzhu found that hospitals generally deal with pharmacological disorders of the elderly.
(Photo by Ou Jiale)
In fact, the Office of the Ombudsman’s proactive investigation report in 2018 recommended that wrong medication be included in the law, and the working group under the SWD also agreed to include provisions in the Regulations, stipulating that institutions “must handle medication properly and Strictly follow the doctor’s prescriptions to assist residents in administering drugs," and has been submitted to the Labor and Welfare Bureau for consideration of legislation.
Member of the Legislative Council, Zhang Chaoxiong, stated that in addition to adding drug accidents as crimes, penalties have been formulated according to varying degrees, including delisting institutions.
In addition, the community organization association recommended that the government set up a blacklist of licensees and a deduction system.
These suggestions are worthy of consideration by the Social Welfare Department, which will further force institutions to improve their services.
It can be said that legal reform, technical and professional support are already in hand to end the incident of distributing the wrong medicine. The key is the determination of the government and the industry.
In case of financial and technical obstacles, the SWD can lend a helping hand, such as increasing the amount and duration of subsidy for pharmacists in hospitals, in exchange for the supervision of the hospitals, and subsidies for the installation of electronic drug delivery systems and staff training costs.
If it is due to improper regulation, speed up the pace and submit the bill to Parliament.
The two can also be viewed in combination. When support increases, the elderly industry is also responsible for improving service standards and accepting stricter regulations.
It is true that sending the wrong medicine is only one of the many faults in the elderly homes.
In the past, the SWD’s regulation of residential care homes was lax. Even though the SWD received 24 cases of abuse in residential care homes from 2015 to 2019, only one case of delisting was in Cambridge nursing homes, and most of the complaints about violations were also issued. .
The public has long criticized the Social Welfare Department for loosing its hands, but they are worried that strict enforcement will lead to the closure of a large number of institutions and the mess will be difficult to deal with.
The Government must muster the courage to increase subsidized places to truly achieve the goal of elderly care.
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