Statistics
A group of researchers meticulously reviewed the statistical evidence and their findings are absolutely shocking. These researchers have authored a paper titled “Death by Medicine” that presents compelling evidence that today’s system frequently causes more harm than good.
This fully referenced report shows the number of people having in-hospital, adverse reactions to prescribed drugs to be 2.2 million per year. The number of unnecessary antibiotics prescribed annually for viral infections is 20 million per year. The number of unnecessary medical and surgical procedures performed annually is 7.5 million per year. The number of people exposed to unnecessary hospitalization annually is 8.9 million per year. The most stunning statistic, however, is that the total number of deaths caused by conventional medicine is an astounding 783,936 per year. [1]
Serious Illness
Dealing with serious illness usually involves the use of many medications, (unless you are lucky, and all you need is surgery, and you are done.) This is why I started this page with statistics, illustrating the dangers inherent with medications.
Following are tips and strategies designed to minimize human error while administering drugs.
Labels
I label all prescription bottles with a black marker, when you have lots of prescription bottles they can start to look the same. 
Spreadsheet
Kayla had a changing regimen of medications, some taken on weekends, others daily, etc. These were a total of 17 different medications with 8 given during her eight week cycles. On top of this Kayla was taking approved supplements. Keeping track of this mentally was difficult. I started making spreadsheets and these saved the day. The first column on the left is the medication/supplement, Next column is dose, followed by time of day given. 
The days of the week are listed in columns so that I can go down the chart, follow the row, knowing what is given on that day and check it off. This evolved to include Kayla’s various activities, such as school, exercise, etc.
The Five Rights
The “Five Rights”—administering the RightMedication, in the Right Dose, at the Right Time, by the Right Route, to the Right Patient—are the cornerstone of traditional nursing teaching about safe medication practice. Taken from http://psnet.ahrq.gov/glossary.aspx United States Department of Health and Human Services. Using your notes in a medical setting are very important as you are keeping a safety net by checking the five rights with every drug dose.
Great Advice from a Care-giver
“I met with the doctors first thing this morning and came out with some of my own rules for any new meds. (meds = abbreviation for medicine)
1. No new meds given at night.
2. No new meds given without the description sheet in my hand prior to administering.
3. No new meds given without my presence in the room
and lastly,
4. No new meds given without her being observed for reactions. Even though they did pre-med her with Benadryl last night, it obviously didn’t catch the horrible adverse reaction she got.”
Please keep in mind that this is applicable to any patient of any age. If an adult patient is very ill, it makes it doubly hard for them to apply these rules. A family member or friend should be there to supervise and help with these crucial steps.
Pain Medications
Keeping track of pain medications is imperative. For these, I note down time and dose on another sheet of paper and attach it to the clipboard that my spreadsheet is on. Get the maximum dosage allowed for the specified time. I always try to use less than the maximum amount, if the pain gets worse we have room to increase the amount. If pain medications are given regularly these can be added to the spreadsheet.
Education
Learn about your disease, its progress and treatments. The more you understand the better it will be to grasp what is happening to you and for you.
The other area of education has to do with your particular medications and side effects. I print out a sheet for each medication and have them all in a file. If a side effect comes up I review the medication file to understand the side effect and how to possibly mitigate it.
Options
Medications come in many different forms. Always check with your doctor on what is available, i.e., pills, capsules, liquid, shots, etc. It takes time, to find out what works better for you. Check with your local pharmascist for specific instructions. I always found out far more information from my local pharmacy than what was given to me by our doctors.
Shots
One of Kayla’s chemos is a shot that can be done at home. When the nurse was teaching me how to do the shots, I asked if Kayla could learn as well. She agreed and taught us both. When Kayla found out that she could give me a shot, you should have seen her face, she was completely delighted. Ever since then, when we do shots at home, she gives me a shot as well. My shot is just saline solution and the needle is really tiny. For those of you who are squeamish, it is nothing. Honestly, I do not feel any pain. Finally, Kayla gets to do something to someone else’s body instead of her always being poked, prodded, and stuck. I do not see any reason why this would not apply to adults in a similar situation. Here is a video of us doing this. We were able to turn a scary procedure into something fun!
Giving Each Other Shots:
Road Map
A road map is a standard protocol for a particular cancer, it is a tool that is used by the medical staff in monitoring your progress through treatment. The treatment plan is laid out and details the type of chemo, dose, and when it is administered. The photo below is an example of part of Kayla’s road map.
On the following pages of our road map, the dosing schedule is laid out by day. I keep a record of all of this. Here is a photo. When Kayla has received the chemo for that day, the slot is crossed off, this way I can follow along as we go. I also have a calendar page that cross references everything on the road map. This may seem overly cautious but this system did catch a major mistake when a nurse accidentally skipped two months of the treatment plan. The abbreviations are for the various chemos. DEX stands for Dexamethasone, which is a steroid.
The road map tells when a chemo is given and by what route: oral, IV, shots or the procedure room. All of these require different preparation such as numbing cream or not eating. 
All of these papers, calendar, notes, and road map are kept in a binder for easy reference and it travels with us for clinic or hospital trips. If there is ever a medical emergency the attending physician will need to have access to this information.
If you are not given a road map when you start treatment, ask for one. If there is no road map available, then ask the doctor for their plan of action for your treatment. Get the treatment plan in writing. This will tell you what chemo, what day and in what dose. Without some sort of treatment plan, you cannot monitor what is happening in order to prevent mistakes.
Medical Paperwork
Please know that patient files are HUGE. Insurance and laws require that every action with the patient is documented fully. By the time a leukemia patient finishes treatment they have, on average, seven thick binders! The amount of behind-the-scenes-paperwork for your chart is pretty astounding. Couple this with many patients, the stress of disease, and medical emergencies, you can see how a lack of involvement could spell disaster. Human error is a high probability and to safeguard against this, YOU must be proactive.
Conclusion
I am sorry this is so long, but I really wanted to give you detailed information for patients going through a new diagnosis with the accompanying shock, confusion, questions and despair. I would have loved some step-by-step information in the beginning of Kayla’s treatment. Hopefully you have found this helpful for you.
References:
1. Death by Medicine
By Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD
http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm
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- Death by Medicine By Gary Null, PhD; Carolyn Dean MD, ND; Martin Feldman, MD; Debora Rasio, MD; and Dorothy Smith, PhD http://www.lef.org/magazine/mag2004/mar2004_awsi_death_01.htm
- ESSAY; Diet Supplements and Safety: Some Disquieting Data By DAN HURLEY Published: January 16, 2007 Published in the New York Times Sunday September 7th, 2008 – Link