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Content ArticleIn this editorial for BMJ Quality & Safety, Dr Tamasine Grimes makes the case for greater patient involvement in managing medication, particularly at points of transition in care. She comments on a recent report on the effects of MARQUIS2, an evidence-based toolkit trialled in North American hospitals to help manage complex medication. The report found that interventions that involved patients in managing their medication had a significant effect in decreasing medication discrepancies, while purely system-level interventions did not.
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Content ArticleThe authors of this research study, published in BMJ Quality & Safety looked at the issues of hazardous prescribing and inadequate monitoring in patients with mental health issues being managed in primary care. They identified a lack of data in this area, despite most patients with mental illness receiving treatment in a primary care setting. The study found that: 9.4% of patients ‘at risk’ triggered at least one indicator for potentially hazardous prescribing. The risk was greatest for patients aged 35–44, females and those receiving more than 10 repeat prescriptions. 90.2% of patients ‘at risk’ triggered at least one indicator for inadequate monitoring. The risk was particularly high in people under the age of 25, females and those with one or no repeat prescription. The authors of the study hope their findings will support providers to reduce risk and improve care for patients who receive mental health treatment in primary care.
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The 21 September 2021 marks World Alzheimer’s Day. This is an international campaign to raise awareness and highlight issues faced by people affected by dementia (dementia is an umbrella term for a number of diseases that affect the brain, with Alzheimer’s disease its most common cause). In this interview, Patient Safety Learning speaks to Alison Keizer, a Mental Health Nurse and trust-wide Dementia Lead, and Fran Hamilton, Occupational Therapist and Deputy Dementia Lead, at Sussex Community NHS Foundation Trust, about the patient safety issues affecting patients with dementia and how they can be supported to reduce risk. -
Content ArticleNICE will speed up patients’ access to the latest and most effective treatments, and dynamic guideline recommendations will be put in the hands of healthcare professionals more quickly under plans unveiled by National Institute for Health and Care Excellence (NICE) in its 5-year strategy.
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Content ArticleMedication reconciliation broadly defined includes both formal and informal processes that involve the comprehensive evaluation of a patient’s medications during each transition of care and change in therapy. The medication reconciliation process is complex, and studies have shown that up to 91% of medication reconciliation errors are clinically significant and 1–2% are serious or potentially life-threatening. The Pennsylvania Patient Safety Reporting System (PA-PSRS) was queried and identified 93 serious events related to the medication reconciliation process reported between January 2015 and August 2020.
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Content ArticleThe Medicines and Medical Devices Bill has received royal assent and has become law. The new Act will enable the Department of Health and Social Care (DHSC) to implement a number of policies to amend the existing regulatory frameworks, although generally regulations under the Act must first be introduced. The potential changes include: Supporting the availability of medicines: enabling hub and spoke arrangements between different legal entities, to ‘support wider use of automation to bring increased efficiencies’; requiring manufacturers to provide electronic patient information leaflets; and increasing the professions able to prescribe and supply certain medicines. Protecting the public: developing a UK medicines verification system; introducing a national registration scheme for online sellers of medicines; and facilitating supply of medicines and medical devices during non-pandemic public health emergencies.
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Content ArticleThe World Health Organization (WHO) third Global Patient Safety Challenge: Medication Without Harm is to reduce severe avoidable medication-related harm globally by 50% in the next 5 years, as it is estimated the worldwide burden of medication errors is in the region of $42 billion. In support of WHO's campaign, the Department of Health and Social Care commissioned a review of the evidence base on medication errors in England to assess the extent and scale of medication error. The Department also established a Short Life Working Group (SLWG) in September 2017 to provide advice to the Secretary of State for Health and Social Care on the scope of a programme of work to improve medication safety.
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Uppsala Monitoring Centre: VigiBase
Patient Safety Learning posted an article in Adverse interactions
VigiBase is the Uppsala Monitoring Centre (UMC)’s starting-point for the journey from data to wisdom about safer use of medicines and wise therapeutic decisions in clinical practice. It is the driving-force at the heart of the work of UMC and the WHO Programme. The purpose is to ensure that early signs of previously unknown medicines-related safety problems are identified as rapidly as possible. VigiBase is the unique WHO global database of individual case safety reports (ICSRs). It is the largest database of its kind in the world, with over 20 million reports of suspected adverse effects of medicines, submitted, since 1968, by member countries of the WHO Programme for International Drug Monitoring. It is continuously updated with incoming reports. -
Content ArticleMedication reconciliation broadly defined includes both formal and informal processes that involve the comprehensive evaluation of a patient’s medications during each transition of care and change in therapy. The medication reconciliation process is complex, and studies have shown that up to 91% of medication reconciliation errors are clinically significant and 1–2% are serious or potentially life-threatening. The Pennsylvania Patient Safety Reporting System (PA-PSRS) identified 93 serious events related to the medication reconciliation process reported between January 2015 and August 2020.
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Prevention of Future Deaths report – Jamie Poole
Patient Safety Learning posted an article in Coroner reports
Jamie Lee Poole was diagnosed required the lifesaving surgery of a kidney transplant in 2011. After the transplant she was placed on a dose of immunosuppressant to prevent rejection of the transplanted kidney. One of the known side effects of the use of the medication is that it can cause low levels of magnesium within the body. Jamie was admitted to the Royal Stoke University Hospital on 27 June 2017 with low levels of magnesium and low calcium and was treated for correction of electrolyte disturbance. On the 28 June 2017 she was found on the floor having collapsed. It was discovered that she had significant swelling on her brain. This was caused by a lack of oxygen to the brain, which was either caused by a heart problem or a seizure, which on balance would have been caused by the low levels of magnesium. She was transferred to the intensive care unit at the Royal Stoke University, Stoke-on-Trent where she died. -
Content ArticlePeople with severe food allergies should carry two adrenaline autoinjector pens with them at all times, according to new guidance. Updated advice from The National Institute for Health and Care Excellence (NICE) says healthcare professionals should always offer people with severe allergies a prescription for two adrenaline auto-injectors (AAIs), which deliver potentially life-saving doses of the hormone to treat anaphylaxis, before being discharged from hospital after emergency treatment. They should also advise patients to always carry two devices with them, the guidance states.
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Content ArticleDo you know your medicines? Do you keep a list? Can you describe and discuss your medicines with healthcare professionals and family when you want to? Ireland's Health Service Executive's National Medication Safety Programme works with patients to improve the safe use of medicines.
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Content ArticleIn my tweets and posts I have suggested that patients themselves need to take more responsibility for the medicines they are prescribed. But what about vulnerable groups who may depend on decisions being made for them, and in their best interests? Whilst there are circumstances where antipsychotic (psychotropic) medicines are an appropriate option for people with autism and learning disabilities, these occasions are limited. In all cases the patient matters most, and any decision to prescribe must be part of a team based, patient-led decision, which is regularly reviewed.
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Content ArticleMore than 30 years have passed since the near-fatal medication error but Michael Villeneuve, CEO Canadian Nursing Association, recalls the moment with absolute clarity.
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Content ArticleAntipsychotic drugs are most commonly prescribed for behavioural and psychological symptoms, such as aggression or hallucinations, in people with dementia. This webpage from the Alzheimer's Society provides information on the prescription of these medications for people living with dementia, their potential side effects, and tips for carers when discussing these treatments with healthcare professionals.
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Content ArticleIn this article, Berlanda et al. discuss the safety of different medical treatments for endometriosis to relieve pain.
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Content ArticleThis survey tool from the Australian Commission on Safety and Quality in Health Care provides Australian health service organisations with a set of 14 principles supported by a variety of risk reduction strategies. The tool is intended for use in hospitals by all clinicians involved in the medication management pathway, including those with governance responsibilities within the health service. The survey tool is also intended to be applied within pharmacy and ward storage environments.
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Content ArticleIn this blog, Steve Turner, a qualified nurse, specialising in clinical educational and patient engagement, offers up four tips for managing medicines in care home settings, under the following headings: Care Homes must have a medicines policy that is regularly reviewed. People must have an accurate listing of their medicines on the day they transfer to the care home. People who live in care homes should have at least 1 multidisciplinary medication review per year. Ensure you have safe systems for administering and recording medicines. To read the full blog and to find out more about each tip, follow the link below.
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Content ArticleHow do we know how a patient is coping with their medicines once they have left our care? How do we know that they are using their medicines safely at home? Surprisingly few medicine errors in children in the home setting are reported, yet evidence suggests that parents sometimes struggle here. We can tackle this hidden medicines safety issue by putting families’ insight at the heart of our interventions. We have to ask. And not least for our infant, children and young adult patients, and their families. Medicines use in this patient group has long been known to be challenging, and many families continue to struggle to use medicines safely at home. But a collaborative approach between healthcare professionals and families can remedy this.
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Content ArticleThe Defective Medicines Report Centre (DMRC) is part of the Medicines and Healthcare products Regulatory Agency (MHRA). The role of the DMRC is to minimise the hazard to patients arising from the distribution of defective medicines by providing an emergency assessment and communication system between manufacturers, distributors, wholesalers, pharmacies, regulatory authorities and users. This guide is for patients, healthcare professionals, manufacturers and distributors for reporting, investigating and recalling suspected Defective Medicinal Products.
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Content ArticleThis article describes what to be expect when coming off of antidepressants, withdrawal problems, the importance of safely tapering off medication and the need for extreme care and support for patients coming off prescribed antidepressants and benzodiazepines.
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Content ArticleIn this article, published by the Harm & Evidence Research Collaborative, Sharon Hartles examines the UK Government’s response in relation to the implementation of the recommendations set out in the Independent Medicines and Medical Devices Safety Review, First Do No Harm report. She explores how the Government’s response has impacted on those harmed by the side effects of Primodos, Mesh and Sodium Valproate.
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At Patient Safety Learning we believe that sharing insights and learning is vital to improving outcomes and reducing harm. That's why we created the hub; providing a space for people to come together and share their experiences, resources and good practice examples. This month, our Content and Engagement Manager, Steph, has hand-picked seven resources, particularly relevant for patient safety managers working in hospital settings. Shared with us by hub members and patient safety advocates, they are jam-packed with practical tools and rich insights. -
Content ArticleThe Government has recently published it's response to the recommendations set out in the First Do No Harm report of the Independent Medicines and Medical Devices Safety Review, chaired by Julia Cumberlege. One of the recommendations was for manufacturers to publish details of payments they make to teaching hospitals, research institutions, and individual clinicians, similar to the American Physician Sunshine Payment Act. The Government has said it is “exploring options to expand and reinforce current industry schemes, including making reporting mandatory through legislation.” In this editorial, Sonia McLeod looks at the gaps that exist in the UK's current system for disclosure and highlights some important considerations when setting up a new system or process if it is to be effective. Read the full article Related reading: A year on from the Cumberlege Review: Initial reflections on the Government’s response (Patient Safety Learning, 23 July 2021) Independent Report of the Patient Reference Group – response to the report of the Independent Medicines and Medical Devices Safety Review (21 July 2021) No such thing as a free lunch – why recording conflicts of interests must be mandatory
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MHRA: Interactive Drug Analysis Profile
PatientSafetyLearning Team posted an article in Mediation
Interactive Drug Analysis Profiles (IDAPs) contain complete listings of all suspected adverse drug reactions or side effects that have been reported to the MHRA via the Yellow Card Scheme for a particular drug substance. This includes all reports received from healthcare professionals, members of the public, and pharmaceutical companies.This Interactive Drug Analysis Profile (iDAP) displays an overview of all UK spontaneous suspected Adverse Drug Reactions (ADRs) reported through the Yellow Card Scheme. It is important to note that reported adverse reactions have not been proven to be related to the drug, and should not be interpreted as a list of known side effects.- Posted
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