New JCAHO Medication Management Standards for 2004

Darryl S. Rich


Am J Health Syst Pharm. 2004;61(13) 

In This Article

Changes Related to Monitoring Response to Therapy

Standard MM.6.10 (formerly TX.3.9) The effects of medication(s) on patients are monitored. The rationale for this standard is that monitoring helps to ensure that drug therapy is appropriate and adverse events are minimized. A patient's response to medication must be monitored according to the clinical needs of the patient, and actual or potential medication-related problems must be addressed. Monitoring includes consideration of the patient's perceptions about adverse effects and, when appropriate, perceived efficacy (e.g., pain relief after administration of an analgesic). Information from the patient's medical record, laboratory test results, clinical response, and the medication profile should be considered in monitoring a patient's response to medications. The organization should have a process for monitoring the response to the first dose of medications that are new to the patient while under the direct care of the organization. This requirement recognizes the higher likelihood of an adverse reaction to a medication that is new to a patient than to a medication that the patient has taken successfully in the past. It will require nursing staff to spend more time at the bedside after first doses. This standard does not apply to drugs given at discharge or drugs given to patients to be administered after they leave the facility. It also does not mean that the first dose of such drugs must be administered in the hospital or clinic.

Standard MM.6.20 The organization responds appropriately to actual or potential adverse drug events and medication errors. JCAHO requires health care organizations to have a plan for responding to an actual or potential adverse drug event (e.g., anaphylaxis). Appropriate actions (and procedures) must be identified in advance and implemented if the event occurs. The organization or responsible individual must comply with internal and external reporting requirements for adverse drug events and medication errors (e.g., send reports to the U.S. Pharmacopeia, FDA, and Institute for Safe Medication Practices). This standard is meant to apply to situations in which an adverse drug event is actually occurring and does not apply to data about the trends of adverse drug reactions.