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Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb
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The Risks of Reflexive Refilling
Olivia R McCarty1, Margaret Pertzborn2, Paul A Bergl3
1Medical College of Wisconsin, Milwaukee, Wisconsin.
WMJ : Official Publication of the State Medical Society of Wisconsin
|October 28, 2021
Summary
Electronic health records and prescribing systems can lead to medication errors. This case highlights how medication reconciliation is crucial for patient safety, especially with automated prescription refills.
Area of Science:
- Medical Informatics
- Clinical Pharmacy
- Patient Safety
Background:
- Electronic health records (EHRs) and electronic prescribing have improved medication management.
- However, automation bias in EHRs and electronic prescribing can lead to errors.
- Overreliance on automated medication lists poses risks.
Observation:
- A 69-year-old man presented with severe symptoms including weakness, weight loss, and bicytopenia.
- Initial evaluation focused on malnutrition and malabsorption.
- A pharmacist identified long-term oral linezolid use as the likely cause.
Findings:
- Discontinuation of linezolid led to rapid symptom resolution and normalization of lab values.
- Linezolid's known side effects include myelosuppression and gastrointestinal issues.
- Reflexive medication refilling contributed to prolonged, unnecessary linezolid use.
Implications:
- Medication reconciliation is essential for accurate diagnosis and treatment.
- Vigilance is needed to prevent errors from automated electronic prescribing.
- Patient and caregiver education on medications is critical for safety.
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