When medications are discontinued or the dose is altered, it is important to remove any doses that are no longer needed as quickly as possible. If the dose is not removed, it may be administered in error, which may lead to an adverse drug event (ADE). Medications that are discontinued or that were prescribed for patients who have been discharged can also become part of "secret stashes," so removing the medications quickly helps prevent illicit hoarding of drugs by staff.
- Use alerts or automatic reports in computerized systems to notify the organization’s pharmacy immediately about discontinued medications and discharged patients.
- Add "removal of medications" to the list of duties if there are regularly scheduled delivery rounds to patient care units.
- Schedule rounds for removal more frequently than deliveries occur.
- Have unit-based pharmacists and technicians regularly identify medications to be removed.
- Ensure that the delivery of medications is timely, especially for dose changes. If the old dose is removed before the new dose arrives, there is a risk that the patient may not receive the dose on time or may not receive any dose at all.