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Why ‘Universal Precautions’ are needed for medication lists
  1. Rita Shane
  1. Correspondence to Dr Rita Shane, Pharmacy Services, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Room A903, Los Angeles, CA 90048, USA; shane{at}cshs.org

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The risks associated with healthcare-acquired infections resulted in the adoption of ‘Universal Precautions’1 within the USA to prevent harmful infections due to bloodborne pathogens. In the USA, the Center for Medicare and Medicaid Services has created an incentive programme for electronic health records that requires implementation of ‘Meaningful Use’ core measures. Among these measures is the requirement that physicians and other individuals who prescribe medications maintain current medication lists. This requirement has increased the use of these lists that frequently contain discrepancies or errors and are then used to create prescriptions and inpatient medication orders.2 Across healthcare settings, a variety of individuals with varying levels of knowledge about medications enter medication histories into electronic health records (EHRs). Errors that are introduced then become ‘hardwired’3 and used for prescribing medications that can cause harm. Much like the presence of bloodborne diseases, clinicians and patients may be unaware of the risk of harm due to erroneous medication lists.

The literature demonstrates that up to 67% of patients on prescription medications have a medication history error or discrepancy on their medication list,4 and 39% of these have the potential to cause moderate to severe harm.3 A recent study to minimise medication history errors in high-risk patients demonstrated 7.4 …

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