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Found 167 results
  1. Content Article
    The Patient Safety Network (PSNet) produces primers which provide guidance on  key topics in patient safety through context, epidemiology and relevant PSNet content. This primer focuses on nurse-related medication administration errors and highlights that despite error reduction efforts through implementing new technologies and streamlining processes, medication administration errors remain prevalent. It covers the background to the issue, low-tech and high-tech prevention strategies and the current context.
  2. News Article
    We have the technology to start a new era in medicine by precisely matching drugs to people's genetic code, a major report says. Some drugs are completely ineffective or become deadly because of subtle differences in how our bodies function. The British Pharmacological Society and the Royal College of Physicians say a genetic test can predict how well drugs work in your body. The tests could be available on the NHS next year. It would have helped Jane Burns, from Liverpool, who lost two-thirds of her skin when she reacted badly to a new epilepsy drug. She was put on to carbamazepine when she was 19. Two weeks later, she developed a rash and her parents took her to A&E when she had a raging fever and began hallucinating. The skin damage started the next morning. Jane told the BBC: "I remember waking up and I was just covered in blisters, it was like something out of a horror film, it was like I'd been on fire." Jane's experience may sound rare, but Prof Mark Caulfield, the president-elect of the British Pharmacological Society, said "99.5% of us have at least one change in our genome that, if we come across the wrong medicine, it will either not work or it will actually cause harm." "We need to move away from 'one drug and one dose fits all' to a more personalised approach, where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines," said Prof Sir Munir Pirmohamed, from the University of Liverpool. Read full story Source: BBC News, 29 March 2022
  3. News Article
    A mental health trust has been served with a warning notice ordering improvements in its processes around rapid tranquillisation of patients. The Care Quality Commission said the trust needed to ensure all staff at Kent and Medway NHS and Social Care Partnership Trust followed local and national recommendations to monitor and record a patient’s physical health when rapid tranquillisation was administered. Inspectors were concerned staff were not always aware of the potential impact of these medications. Serena Coleman, CQC deputy director of operations in the south, said: “We found some staff weren’t always using the least restrictive options to make sure that people’s behaviour wasn’t controlled by an excessive use of medicines. “As required medication, such as lorazepam and promethazine, was being used quite frequently but we couldn’t always find records to explain why these medications were necessary. There were examples where reviews hadn’t happened for long periods, meaning staff couldn’t be sure it was still appropriate to administer to people." Read full story (paywalled) Source: HSJ, 3 August 2023
  4. News Article
    Hospitals must start using “smart” intravenous (IV) infusion technology to its full potential if they are to prevent dangerous drug errors, University of Manchester researchers have found. ‘Smart pumps’- which automatically calculate the dose and rate of different drugs before they are pumped into a vein - prevent potentially fatal errors by stopping the administration of the wrong rate. But according to the study published in BMJ Open Quality, though the technology probably saved the lives of 110 people in two Trusts over a year, it has largely failed to be adopted by hospitals. Though many IV pumps used in hospitals have a smart capability, most trusts do not utilise the functionality because they are difficult to configure and maintain. Smart pumps are usually configured by a pharmacist and checked by a consultant or senior nurse. Conventional pumps, however, are set by ward staff who calculate and input infusion rates themselves - increasing the risk of drug errors. The risks are illustrated by previous work from the Manchester team, who demonstrated that 1 in 10 IV drug administrations are associated with an error, and up to 1 in 10 of those were associated with harm. Read full story Source: University of Manchester, 1 August 2022
  5. News Article
    A nurse who recorded she had given medication to care home residents when in fact she had delegated the task to unqualified staff has been struck off. Adelaide Maloane was working a night shift at Somerleigh Court in Dorchester, Dorset, in August 2019 when the incident took place. Ms Maloane delegated giving 16 medicines to residents to an unqualified healthcare assistant at the home. The Nursing and Midwifery Council said Ms Maloane had "failed to acknowledge the seriousness of her misconduct and dishonesty and the implications of her actions for residents, colleagues and the reputation of the nursing profession". Read full story Source: BBC News, 21 July 2022
  6. News Article
    The Food and Drug Administration will consider an application for the first birth control pill to be sold without a prescription. The application from HRA Pharma would seek to make Opill – an every day, prescription-only hormonal contraception first approved in 1973 – available over-the-counter. Such an approval from the FDA would allow people to purchase “the pill” without a prescription for the first time since oral contraceptives became widely available in the 1960s. The application will also cast oral contraceptives into a fraught political moment in the US. The US supreme court ended federal protection for abortion rights late last month, throwing into question the future of birth control. “This historic application marks a groundbreaking moment in contraceptive access and reproductive equity in the US,” said HRA Pharma’s chief strategic operations and innovation officer, Frédérique Welgryn. “More than 60 years ago, prescription birth control pills in the US empowered women to plan if and when they want to get pregnant.” Making birth control available without a prescription will “help even more women and people access contraception without facing unnecessary barriers”, said Welgryn, whose company has already submitted the application. Read full story Source: The Guardian, 11 July 2022
  7. News Article
    A doctor who attempted to cover up the true circumstances of the death in 1995 of a four-year-old patient has been struck off. Consultant paediatric anaesthetist Dr Robert Taylor dishonestly misled police and a public inquiry about his treatment of Adam Strain, who died at the Royal Belfast Hospital for Sick Children, a medical tribunal found. The youngster was admitted for a kidney transplant at the hospital following renal failure but did not survive surgery in November 1995. Six months later an inquest ruled Adam died from cerebral oedema – brain swelling – partly due to the onset of dilutional hyponatraemia, which occurs when there is a shortage of sodium in the bloodstream. Two expert anaesthetists told the coroner that the administration of an excess volume of fluids containing small amounts of sodium caused the hyponatraemia. But Dr Taylor resisted any criticism of his fluid management and refused to accept the condition had been caused by his administration of too much of the wrong type of fluid. In 2004 a UTV documentary When Hospitals Kill raised concerns about the treatment of a number of children, including Adam, and led to the launch of the Hyponatraemia Inquiry. The tribunal found Dr Taylor acted dishonestly on four occasions in his dealings with the the public inquiry, including failing to disclose to the inquiry a number of clinical errors he made and falsely claiming to detectives he spoke to Adam’s mother before surgery. Read full story Source: The Independent, 22 June 2022
  8. News Article
    Vulnerable patients cared for in secure mental health units across England could miss out on vital medications due to a shortage of learning disability nurses, the Healthcare Safety Investigation Branch (HSIB) has warned. The report into medication omissions in learning disability secure units across the country highlights problems with retaining learning disability nurses, with the number recruited each year matching those leaving. Figures quoted in the report suggest the number of learning disability nurses in the NHS nearly halved from 5,500 in 2016 to 3,000 in 2020. The HSIB launched a national investigation after being alerted to the case of Luke, who spent time in NHS secure learning disability units but was not administered prescribed medication for diabetes and high cholesterol on several occasions. At Luke’s facility, which included low and medium secure wards, HSIB investigators considered that the quality and style of care provided to patients had been directly impacted by a lack of nurses with required skill sets. Findings from HSIB’s wider national investigation link a shortfall of learning disability nurses to instances of patients missing their medication, with the report’s authors describing a “system in which medicines omissions were too common and prevention, identification and escalation processes were not robust”. Read full story (paywalled) Source: HSJ, 23 June 2022
  9. News Article
    Some pharmacies run by the High Street chain Boots have been criticised for telling some patients on multiple drugs that they can no longer have blister pack boxes, known as dosette boxes or multi-compartment compliance aids (MCCAs). Weekly pill organisers can help users keep track of their daily medication and stay safe. Pharmacists put the tablets into individual boxes in the trays, each one indicating when they should be taken. The NHS says boxes are not always available for free on the NHS and they're not suitable for every type of medicine. Tracey Hobbs' mother, Pat Garner, lives at home with care visits. For several years, she has had her MCCAs provided by her local Boots pharmacy. She takes more than 15 pills each day. Tracey says she was phoned by Boots and told that from one month later her mother would receive all the drugs in the original packaging, rather than organised into morning and night doses for each day of the week. Tracey told the BBC: "I pointed out that the blister packs were the only way we could know she had taken her medication at the right time. Handing seven individual boxes with different instructions on each one was totally unworkable and - quite frankly - dangerous". A Boots spokesperson said: "The latest Royal Pharmaceutical Society guidance indicates that the use of multi-compartment compliance aids is not always the most appropriate option for patients that need support to take their medicines at the right dose and time." "Pharmacists are speaking with patients who we provide with MCCAs to discuss whether it is the right way to support them, depending on their individual circumstances and clinical needs." Prof Gill Livingston, an expert in elderly medicine at University College London, said she was concerned to hear that some patients and their families were being told the boxes were being scrapped. She said: "Blister packs enable people with mild dementia or some memory problems to take their own medication and remain independent. They can check that they have taken it and they know they have taken the right thing, as it is already sorted out. "Later on in dementia or with other disabilities, it enables paid carers and families to help them take their medication and remain in the community and remain as well as possible." Read full story Source: BBC News, 21 June 2022
  10. News Article
    When a couple decides to try to have a child by in vitro fertilisation, it’s often accompanied by anticipation, anxiety and worry about whether the egg and sperm will unite and produce a healthy baby. So when the procedure to retrieve eggs from a woman’s ovary turns out to be physically painful, it can create long-term emotional pain as well, according to a lawsuit and two women who underwent the procedure at the Yale University Reproductive Endocrinology and Infertility Clinic. They are among dozens of women and spouses who are suing Yale University, claiming the staff at the clinic should have known that, instead of receiving fentanyl to relieve pain during the procedure, they instead were being injected with saline — salt water. “The result was that dozens, perhaps hundreds, of women underwent the most painful fertility surgeries and procedures offered at the REI Clinic with little or no analgesia,” the lawsuit states. Angela Cortese, 33, of Vernon, who first had her eggs retrieved on Dec. 3, 2019, said the pain was “excruciating” as a nurse wiped tears from her eyes and Cortese tried “not to flinch every time they’re using this giant needle to retrieve the follicles.” “I want to say it was probably around 45 minutes that I was very much aware of what exactly was happening and feeling every pinch and prod,” she said. “And it doesn’t feel like somebody’s just pinching you. It feels like somebody’s stabbing you through your vagina. It was horrific.” Read full story Source: ctpost, 31 May 2022
  11. News Article
    High risks relating to the ordering, prescribing, storing and administration of medicines have been found by the Mental Health Commission in a series of inspections of mental health centres in Dublin. The commission emphasised the need to have appropriate practices including the recording of the minimum dose interval information; where medication has been stopped, the stop date to be recorded; and the need to always have the prescriber’s signature recorded. The inspector of mental health services Dr Susan Finnerty said it was positive to see centres maintaining high compliance rating, but spoke of concerns around the administration of medication. “We know that medication is an important tool in treatment of mental illness. In order to reduce the risk of medication errors, we need to be sure that medication prescription and administration records are completed correctly,” Dr Finnerty said. Read full story Source: Independent Ireland, 18 January 2023
  12. Content Article
    There is little longitudinal information about the type and frequency of harm resulting from medication errors among outpatient children with cancer. This study aimed to characterise rates and types of medication errors and harm to outpatient children with leukaemia and lymphoma over 7 months of treatment.
  13. Content Article
    In this study, Hawkins and Morse explored nurses’ work in the context of medication administration, errors and the organisation. Secondary analysis of ethnographic data included 92 hours of non-participant observation, and 37 unstructured interviews with nurses, administrators, and pharmacists. Think-aloud observations and analysis of institutional documents supplemented these data. Findings revealed the nature of nurses’ work was characterised by chasing a standard of care, prioritising practice and renegotiating routines. The rich description identified characteristics of nurses’ work as cyclical, chaotic and complex, shattering studies that explained nurses’ work as linear. A new theoretical model was developed, illustrating the inseparability of nurses’ work from contextual contingencies and enhancing our understanding of the cascading components of work that result in days that spin out of the nurses’ control. These results deepen our understanding why present efforts targeting the reduction of medication errors may be ineffective and places administration accountable for the context in which medication errors occur.
  14. Content Article
    This study by a team at the University of Derby in the British Journal of Anaesthesia used experimental psychology methods to explore the potential benefits of colour-coded compartmentalised trays compared with conventional trays in a visual search task.  The authors found that errors were detected faster when presented in the colour-coded compartmentalised trays than in conventional trays, a finding that was replicated for correct responses for error-absent trays. Overall, colour-coded compartmentalised trays were associated with significant performance improvements when compared with conventional trays.
  15. Content Article
    This blog by Dr Anna Bayes from Altera Digital Health looks at the benefits of closed-loop medication administration (CLMA) in preventing avoidable medication errors. CLMA provides an extra validation at the point of drug administration by using barcode technology to positively identify the patient and validate their prescribed medications against the physical medication product (for example, pills, infusions or creams) at the point of care. Anna also considers CLMA's role in advancing digital maturity.
  16. News Article
    Doctors have criticised new health secretary Therese Coffey over reports that pharmacists will be allowed to prescribe antibiotics without the approval of a doctor. According to The Times, Ms Coffey’s “Plan for Patients” will give pharmacists the power to prescribe certain drugs, such as contraception, without a prescription in an effort to reduce the need for GP appointments and tackle waiting lists. Responding to reports of the plans, Rachel Clarke, an NHS palliative care doctor and writer, wrote on Twitter: “This is staggeringly irresponsible of Therese Coffey and will cause so much more harm than good. “Doctors do not – unlike Coffey – dish out spare antibiotics to our family and friends because we’re painfully aware of the harms of antibiotic resistance. Utter recklessness.” Stephen Baker, a professor at Cambridge University and an expert in molecular microbiology and antimicrobial resistance, branded the health secretary’s plans “moronic”. He told the newspaper that the more antibiotics were used “the more likely we are to get drug-resistant organisms”. He added that it was “nuts” to consider widening access to drugs, adding that resistance against antibiotics is “clearly one of the biggest problems humanity is facing in respect of infectious disease at the moment”. Read full story Source: The Independent, 17 October 2022
  17. News Article
    A French study of adverse drug reactions has a highlighted a link between drug shortages and medication error. Data from the French Pharmacovigilance Database show that medication errors were identified in 11% of the 462 cases mentioning a drug shortage. The researchers found that medication errors usually occurred at the administration step and involved a human factor. “A drug shortage may lead to a replacement of the unavailable product by an alternative,” the researchers wrote. “However, this alternative may have different packaging, labelling, dosage and sometimes a different route of administration that may increase the risk of a medication error.” Read full story (paywalled) Source: The Pharmaceutical Journal, 11 October 2022
  18. News Article
    Many pharmacies and physicians are forced to deny patients access to drugs, such as methotrexate, that can be used to help induce an abortion A few weeks after the supreme court’s 24 June decision to overturn the nationwide abortion rights established by Roe v Wade, the pharmacy chain Walgreens sent Annie England Noblin a message, informing her that her monthly prescription of methotrexate was held up. Noblin, a 40-year-old college instructor in rural Missouri, never had trouble getting her monthly prescription of methotrexate for her rheumatoid arthritis. So she went to her local Walgreens to figure out why, standing in line with other customers as she waited for an explanation. When it was finally her turn, a pharmacist informed Noblin – in front of the other customers behind her – that she could not release the medication until she received confirmation from Noblin’s doctor that Noblin would not use it to have an abortion. Since the supreme court’s elimination of federal abortion rights, many states have been enacting laws which highly restrict access to abortion, affecting not only pregnant women but also other patients as well as healthcare providers. As a result, many pharmacies and physicians have been forced to deny and delay patients’ access to essential medications – such as methotrexate – that can be used to help induce an abortion. Noblin is one of the 5 million methotrexate users across the US and one of the country’s many autoimmune patients. Although she was eventually given her prescription, Noblin and other patients are now forced to grapple both with a monthly invasion of privacy at pharmacies that ask them about their reproductive choices as well as the possibility of being wholly denied the medication in the future due to restrictive laws. Read full story Source: The Guardian, 26 September 2022
  19. Content Article
    The Medicines and Healthcare products Regulatory Agency issued this guidance following recent cases, including cases with fatal outcomes, in which patients have received the wrong medicine due to confusion between similarly named or sounding brand or generic names.
  20. Content Article
    Electronic prescribing (ePrescribing) systems allow healthcare professionals to enter prescriptions and manage medicines using a computer. Sheikh and colleagues set out to find out how these ePrescribing systems are chosen, set up and used in English hospitals. Given that these systems are designed to improve medication safety, we looked at whether or not these systems affected the number of prescribing errors made (mistakes such as ordering the wrong dose of medication). They also tried to see whether or not the systems were good value for money (or more cost-effective). Finally, they made recommendations to help hospitals choose, set up and use ePrescribing systems.
  21. News Article
    All NHS hospitals in England have been told to destroy a powerful medicine mistakenly used by staff because its packaging looks the same as another drug. A national safety alert was issued following several incidents, including two deaths of babies, in which patients were inadvertently given a dose of sodium nitrite – which is used as an antidote to cyanide poisoning – rather than sodium bicarbonate. The errors are thought to have been caused by similarities between the labelling and drug packaging used by manufacturers. Now hospitals have been told to check all wards and medicine storage areas for sodium nitrite and to destroy any of the unlicensed product. The drug should only be available in emergency departments and may have been supplied to medical wards by mistake. There are an estimated 237 million medication errors in the NHS every year – with a third linked to packaging and labelling. Read full story Source: The Independent, 9 August 2020
  22. News Article
    People with chronic pain that can’t be explained by other conditions should not be prescribed opioids because they do more harm than good, the medicines watchdog has warned. The National Institute for Health and Care Excellence (NICE) has said people should instead be offered group exercise, acupuncture and psychological therapy. In new draft guidance, NICE said most of the common medications used for chronic primary pain has little or no evidence to support their use in patients aged over 16. Its latest guidance comes amid concerns over the level of opioid use. In September last year a review by Public Health England found 1 in 4 adults have been prescribed addictive medications with half of them taking the drugs for longer than 12 months. NICE’s new draft guidance said some antidepressants should be considered for people with chronic primary pain but it said paracetamol, non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen, as well as benzodiazepines or opioids should not be given because of concerns they might do more harm than good. Read full story Source: The Independent, 4 August 2020
  23. News Article
    Intensive care units across the country are running out of essentials, including anaesthetics and drugs for anxiety and blood pressure, after a “tripling of demand” sparked by the coronavirus pandemic. Six senior NHS doctors working on the front line, and drugs industry sources, say that the health service is running out of at least eight crucial drugs. Hospitals in London, Birmingham and the northwest of England have been especially badly hit. Doctors said they were being forced to use alternatives to their “drug of choice”, affecting the quality of care being provided to COVID-19 patients. They also warned that some second-choice drugs might be triggering dangerous side effects such as minor heart attacks. Ron Daniels, an intensive care consultant in the West Midlands, said the shortages had become “acute” already. “We don’t know what we’re going to run out of next week,” he said. “Safety isn’t so much the issue — it’s quality. It may be that we’re subjecting people to longer periods of ventilation than we would normally because the drugs take longer to wear off.” Daniels added that some of the “second-line drugs” being used might be challenging to a patient’s heart: “We might be causing small heart attacks or subclinical heart attacks.” Ravi Mahajan, president of the Royal College of Anaesthetists, said work was being carried out to “preserve” key drugs for those most in need. Read full story (paywalled) Source: The Times, 26 April 2020
  24. News Article
    Experts have criticised NHS advice that people self-isolating with Covid-19 should take ibuprofen, saying there is plausible evidence this could aggravate the condition. The comments came after French authorities warned against taking widely used over the counter anti-inflammatory drugs. The country’s health minister, Olivier Véran, a qualified doctor and neurologist, tweeted on Saturday: “The taking of anti-inflammatories [ibuprofen, cortisone … ] could be a factor in aggravating the infection. In case of fever, take paracetamol. If you are already taking anti-inflammatory drugs, ask your doctor’s advice.” NHS guidance states that people managing Covid-19 symptoms at home should take paracetamol or ibuprofen. “I would advise against that,” said Prof Ian Jones, a virologist at the University of Reading. “There’s good scientific evidence for ibuprofen aggravating the condition or prolonging it. That recommendation needs to be updated.” Read full story Source: The Guardian, 16 March 2020
  25. News Article
    A shortage of contraception is causing chaos and risks unplanned pregnancies and abortions, doctors are warning. Leading sexual health experts have written to ministers warning that the supply shortage of contraceptives is beginning to lead to serious problems across the UK. A number of daily pills and a long-acting injectable contraceptive are thought to be affected, including Noriday, Norimin and Synphase. The problem follows a shortage of hormone replacement therapy for menopausal women last year. It is unclear how many women use these types of contraception - overall around three million women take daily pills, and more than 500,000 use long-acting contraception, such as coils, implants and injections. The Royal College of GPs said its members were doing their best to help women find alternatives - there are many different types of daily pill available. Faculty president Dr Asha Kasliwal said; "We are aware that women are sent away with prescriptions for unavailable products and end up lost in a system. This is causing utter chaos." The faculty has teamed up with the Royal College of Obstetricians and Gynaecologists and the British Menopause Society to write to ministers, asking them to set up a working group to address the problems. The letter warns women are becoming distressed by having to find alternative products that might not necessarily suit them or go without contraception altogether. It said this was affecting the "physical and mental wellbeing of girls and women" and could lead to a "rise in unplanned pregnancies and abortions". Read full story Source: BBC News, 7 February 2020
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