The labeling of medications may seem like a standard practice that you don’t give much thought to. For healthcare professionals, reading a medication label, filling a prescription, or labeling IV tubing is just another daily task. But the importance of what goes on those labels can make the difference between preventing or causing a medication error. In one study, up to 25% of errors are due to name confusion, and 33% are related to packaging and labeling mistakes. According to a report called “Preventing Medical Errors,” poor labeling is a central cause for medication errors leading to approximately 1.5 million preventable adverse drug events each year. The keyword here is preventable. These errors account for thousands of deaths and millions of dollars in healthcare costs annually. It is crucial that medication labels are accurate, clear, and easy to comprehend.
Not only are labels imperative to medications, but also to many other healthcare operations. Nurses, surgical services and nonclinical departments all use labels to warn, communicate, clarify, instruct, and organize. Most hospitals have policies surrounding label use and FDA regulations ensure accuracy and standardization. As you read through the following information, consider the amount of times you encounter labels and the importance they offer to patients and healthcare professionals alike.
Medication Labels
The basics of medication labels include the drug name, dosage, and directions. Medication labels should always include warnings regarding safety. This could be a warning of the potential for drowsiness, interactions with other medications, or a maximum dosage alert.
You can see some of the different features on medication labels on vials used in inpatient facilities below. To ensure the professional administering the medication calculates the correct dose, the concentration measurement (1mg/1mL) is included. These labels also address how to administer the medication and if there is a need to dilute or reconstitute. There may also be other icons or phrases helpful for medical providers such as the mention that this drug is a schedule 2 controlled substance. You can find more information, such as side effects and precautions in the package insert.
Over-the-Counter vs. Prescription Labels
Obviously the largest key difference between prescription and over-the-counter (OTC) medications is that doctors or authorized medication providers order prescriptions. The provider has prescribed the medication to a patient for a specific ailment and should have reconciled its use against the patient’s allergies and other medications.
Four out of five American adults take an OTC drug. OTC medications are often used to treat an array of minor illnesses and have a wider margin of error. OTC labels are called “Drug Facts” and are usually located on the back of the medication bottle/package/tube.
Prescription medications often come with pharmacy information sheets and medication guides which contain the basic drug information, intended uses, side effects, risks, and precautions. Prescription labels are more complicated and according to Consumer Reports, over half a million Americans misinterpret the instructions on their bottles every year.
FDA Regulations For Medication Labels
In 2002, the FDA began imposing a new regulation that OTC drugs follow a simplified and standardized format. This includes six main parts. Some medications include a seventh component: a phone number to call with questions.
Unfortunately, there is no nationwide standard for prescription medication labels. The FDA does require the patient’s name and dosage instructions, but other details vary by state. Each state’s board of pharmacy is responsible for what goes on the Rx labels.
While the FDA does not monitor the pharmacy information sheets mentioned previously, they do have requirements for the prescribing information. To be fair, the FDA considers these the true “prescription drug label.” The FDA reviews the information regularly for accuracy and updates any changes on DailyMed. The inserts are written for healthcare professionals. Patients may need help in understanding these inserts. In 2006, the FDA issued a final rule that changed the format of these labels into highlighted sections in a shortened page-long summary with expanded information available on each highlighted area.
The FDA also requires a medication guide to be given with each prescription. Unfortunately, this doesn’t always happen and not all drugs have a medication guide. This information is available on the drug manufacturer’s website or also on DailyMed. It includes information similar to that of an OTC drug such as the use of the medication, possible side effects, and ingredients. It is required to be written in easy-to-understand language for patients.
Educating Patients on Interpreting Medication Labels
Health literacy is a major component of understanding medication labels. Close to 50% of adults incorrectly interpret at least one medication label. This undoubtedly has poor health consequences if a patient is taking a medication incorrectly. The concern rises as providers prescribe multiple medications for patients with multiple comorbidities. Patients often take these medications at specific times each day.
Pharmacists, nurses, and physicians play an integral part in ensuring patients can correctly interpret their medication labels. Healthcare professionals should take the time to address any inconsistencies observed. The teach-back method is a great way of accomplishing this. After educating the patient on how to read their medication bottles or packages, have the patient teach it back to you. This can also include observing them drawing up or administering a medication for accuracy. Other tools could include utilizing a pillbox, blister pack, or simplifying their medication regimen to prevent errors.
Inpatient labeling
The use of labels within hospitals and healthcare facilities is broad. You will likely find labels in every department. Just like with medication labels, the goal is to alert and prevent errors. Medical records use labels to organize and assist with billing and coding. Environmental services use labels to protect themselves and others by labeling harmful chemicals. Providers may label equipment if it is broken or needs special precautions. The main point of labels is to communicate. Humans make mistakes and labeling provides an extra safety measure.
The following departments rely on labels to communicate with each other and ensure safe patient care:
Pharmacy
Inpatient pharmacies often label medications and IV bags prior to delivering to other departments. These labels may alert a practitioner to use caution when administering, to protect from light, or to note a change from the original order. Allergy labels are also common and can be life-saving, especially for patients with severe allergies such as anaphylaxis.
Nursing
Nurses use many different kinds of labels. These can include labels on patient charts or ID bands to note important restrictions such as a do not resuscitate order or to identify a patient that is a fall risk.
Nurses should also use labels for their IV tubing. Critical care nurses often have multiple IV medications infusing at once. Keeping them separated is vital as some medications are not compatible. Hospitals have policies in place stating when tubing needs changing as an infection control measure. For example, you must check tubing for enteral nutrition every 24 hours. IV labels that allow nurses to write the date or to change on a specific day (Monday, Friday) is a quick and easy way to improve care.
Anesthesia and surgical services
Mistakes in the operating room can have dire consequences. Some medications are “look-alike sound-alike” and labels calling attention to this have the potential to prevent a catastrophe.
Providers must monitor and titrate drugs used during anesthesia very closely. Labels take the place of illegible handwriting, decreasing confusion and misidentification. An anesthetic may be infusing at the same time as normal saline, but you certainly don’t want them infusing at the same rate! Keeping medications labeled accurately and separately is an easy, cost-effective, and life-saving step worth taking.
Caresfield understands the importance of simple, easy-to-read labels. Our labels offer bright eye-catching colors, large, bold fonts, and helpful icons. Whether you need allergy labels for nursing, IV labels for anesthesia, or Rx labels for pharmacy and patient dispensing, our labels serve the purpose of promoting safety and preventing unnecessary errors.
Related: Barcode Labeling: It Saves Time, Money and Lives.
Maegan Wagner, BSN RN CCM has over 10 years of healthcare experience. Her nursing career has led her through many different specialties, but her passion lies in educating through writing for other healthcare professionals and the general public.
