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Content ArticlePoor health literacy can inhibit patient or caregiver understanding of care instructions and threaten patient safety. This cross-sectional study from Selzer et al. of medically complex children treated at one academic hospital in Austria reveals that despite high levels of satisfaction with care, many caregivers do not understand medication management instructions at discharge. Misunderstandings were more likely to occur with higher numbers and/or new prescriptions, poor medication-related communication, and language or literacy barriers.
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Content ArticleThis is a safety critical and complex National Patient Safety Alert. Implementation should be co-ordinated by an executive lead (or equivalent role in organisations without executive boards) and supported by clinical leaders in diabetes, GP practices, pharmacy services in all sectors, weight loss clinics, private healthcare providers and those working in the Health and Justice sector.
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News Article
EU plan for medicine stockpile could worsen UK’s record shortages
Patient Safety Learning posted a news article in News
The EU is to stockpile key medicines that will worsen the record drug shortages in the UK, with experts warning that the country could be left “behind in the queue”. The EU is seeking to safeguard its supplies by switching to a system in which its 27 members work together to secure reliable supplies of 200 commonly used medications, such as antibiotics, painkillers and vaccines. But the bloc’s move to insulate itself from growing drug shortages threatens to exacerbate the increasing scarcity of medicines facing the NHS, posing serious problems for doctors. “Europe is securing access to key drugs and vaccines as a single region, with huge influence and buying power. As a result of Brexit the UK is now isolated from this system, so our drug supplies could be at risk in the future,” said Dr Andrew Hill, an expert on the pharmaceutical trade. Britain is experiencing a record level of drug shortages, with more than 100 – including treatments for cancer, type 2 diabetes and motor neurone disease – scarce or impossible to obtain. Mark Dayan, the Brexit programme lead at the Nuffield Trust health thinktank, said the EU’s decision to act as a buying cartel could seriously disadvantage Britain. “There is a real risk that measures in such a large neighbour, which is now a separate market due to Brexit, will leave the UK behind in the queue when shortages strike,” Dayan said. It also has an initiative for member states to transfer stocks of medicine to cover shortages in others. These measures could shut UK purchasers out in certain scenarios. “This would risk worsening shortages from a starting point where they are already exceptionally severe for the UK and other countries, with a mounting impact in terms of costs and wasted time for the NHS, and in terms of patients struggling to get what their doctors have said they need.” Read full story Source: The Guardian, 25 January 2024 Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do. -
Content ArticleMedicine shortages in the UK have been a regular feature on newspaper front pages in recent years. As a doctor on the frontline, Ammad Butt sees how this instability in our medicine supply chain is playing out on the ground. Ammad works in a large city hospital and is used to meeting disgruntled patients who have had to wait hours in clinic to receive treatment. But just imagine their concern when he has to explain to them that the medication they usually took to treat them with is not available, and that they will have to take an alternative instead or stay in hospital for even longer as a result. In the past year, Ammad has routinely seen patients having to go without medication for common conditions such as attention deficit hyperactivity disorder (ADHD), diabetes and even acne that would otherwise be easily managed, or being forced to take alternatives that are less appropriate. And new EU plans for its members to work together to stockpile key medicines will only worsen shortages in the UK. Patients tell Ammad they feel others are receiving better treatment than they are. And they are right, in some ways. Healthcare professionals are being put in a difficult situation having to explain why they are making compromises in their care. It all adds to the sense among patients and healthcare professionals alike that the health service is not working for the most vulnerable. Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy? Have you (or a loved one) ever been prescribed medication that you were then unable to get hold of at the pharmacy or in hospital? To help us understand how these issues impact the lives of patients and families, please share your experience and insights in our hub community thread on the topic here or drop a comment below. You'll need to register with the hub first, its free and easy to do.
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Content ArticleAntibiotic resistance is an increasing problem in healthcare, especially in nursing homes where up to 75% of antibiotics are prescribed inappropriately. This series of webinars from the Pennsylvania Patient Safety Authority covers various aspects of antibiotic stewardship including: Types of antimicrobials Why antibiotic stewardship and who should be at the table Antimicrobial usage Mechanisms of antimicrobial resistance Antibiograms Antimicrobial baseline data Developing an antimicrobial stewardship plan Antimicrobial usage data
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Content ArticleThis resource library has been created by Health Innovation West of England to provide support materials in one location for people living with pain and professionals supporting people living with pain.
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Content Article
This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Benjamin talks about why we need a radical shift in how we view and treat people with chronic pain and how over-investigation and over-treatment compromise patient safety. He also talks about the power of communal singing for people with long-term conditions and what wild swimming has taught him about supporting people living with chronic pain.- Posted
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Content Article
Parkinson's Disease awareness video
PatientSafetyLearning Team posted an article in Neurological conditions
In this film the team at Leeds Teaching Hospitals NHS Trust provide an overview of Parkinson's and why it is important that medication is administered properly and on time. They also talk about improvements they have made in their own practice, and offer tips around medication management for Parkinson's.- Posted
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Content ArticleNew safety and educational materials have been introduced for men and women and healthcare professionals to reduce the harms from valproate, including the significant risk of serious harm to the baby if taken during pregnancy and the risk of impaired fertility in males. These safety and educational materials support the new regulatory measures announced in the National Patient Safety Alert. Healthcare professionals should review the new measures and materials and integrate them into their clinical practice when referring patients and when prescribing or dispensing valproate.
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News Article
National shortage of epilepsy medication putting thousands at risk
Patient Safety Learning posted a news article in News
A national shortage of epilepsy medication is putting patients' safety at risk, consultants have said. Medical professionals are becoming genuinely concerned as ever more frequent supply issues continue to bite tens of thousands of sufferers. According to the Epilepsy Society charity, over 600,000 people in the UK have the condition, or about one in every 100 people. Among them is Charlotte Kelly, a mother of two living in London who has had epilepsy for over 20 years. She must take two tablets a day to manage her condition but issues with supply have forced her to start rationing her medication. Speaking to Sky News, Ms Kelly told us of the fear surrounding the restricted access to the medicate she needs to survive. "I'm scared. If I'm truly honest, I'm scared knowing that I might not get any medication for a few weeks, or a couple of months, I just don't know when. "It's scary to know that I have to worry about getting hold of medication. I do believe that something needs to happen very quickly because even if it's pre-ordered there's no guarantee you're going to get it. Speaking to Sky News, Professor Ley Sander, director of medical services at the Epilepsy Society, says the supply concern is not just on the minds of patients but those in the industry too. "It might be that we need a strategic reserve for storage of drugs, we might have to bring drugs over from other parts of the world to avoid this from recurring. "We're not at that point yet, but this is an urgent issue." Read full story Source: Sky News, 21 January 2024 -
Content Article
FDA drug shortages database
Patient-Safety-Learning posted an article in Medication including labelling
Medication shortages can occur for many reasons, including manufacturing and quality problems, delays and discontinuations. This Food and Drug Administration (FDA) database provides information on drugs with a supply issue. Information is provided to the FDA by manufacturers. -
News Article
People buying opioids and sedatives online face deadly fakes, expert warns
Patient Safety Learning posted a news article in News
People trying to buy illicit synthetic opioids and sedatives online to treat pain, anxiety and insomnia increasingly risk taking a different drug that has caused dozens of deaths among heroin users, a leading expert has warned. Nitazenes – synthetic and extremely powerful drugs implicated in fatalities of chronic powdered heroin users in Birmingham, Bristol and London in recent months – have been detected in illicit supplies of tablets being sold as diazepam and codeine that appeal to a wider market. New figures released to the Guardian by the National Crime Agency reveal 65 people have died from taking nitazenes in the past six months – more than two a week, while detections in drug supplies have increased more than fivefold in the last two years. “[Nitazenes] are being mixed into heroin but it is also in fake diazepam, fake codeine and the person buying the tablets online is a very different kind of user to a heroin user,” Dr Caroline Copeland, the director of the National Programme on Substance Abuse Deaths said. “It means the risk is much wider.” Read full story Source: The Guardian, 17 January 2024 -
News Article
NHS medicines shortage putting lives at risk, pharmacists warn
Patient Safety Learning posted a news article in News
An unprecedented medicines shortage in the NHS is endangering lives, pharmacists have said, as unpublished figures reveal that the number of products in short supply has doubled in two years. A treatment for controlling epileptic seizures was the latest to be added on Wednesday to a UK drugs shortage list that includes treatments for conditions ranging from cancer to schizophrenia and type 2 diabetes. Causes of the crisis are thought to include the plummeting purchasing value of the pound since the Brexit referendum, which reduces the NHS’s ability to source medicines abroad, and a government policy of taxing manufacturers. According to Department of Health and Social Care (DHSC) figures provided to the British Generic Manufacturers Association, there were 111 drugs on a shortages list on 30 October last year and 96 on 18 December, with supply notifications issued for a further 10 treatments to NHS providers in the UK since then. It amounts to a 100% increase in shortages compared with January 2022, with pharmacists and health charities claiming the conditions of some patients were deteriorating as a result. Delyth Morgan, the chief executive of Breast Cancer Now, said her organisation had been contacted over the past 12 months by several patients unable to source the medicines they needed to control the spread of their disease. She said: “Last year many people shared with us, via Breast Cancer Now’s helpline, that they’d been facing difficulties accessing their hormone treatment including letrozole, anastrozole and tamoxifen, causing them huge worry and anxiety. Trying to track down a treatment by travelling to a number of different pharmacies is an added burden for patients at an already difficult time. “It may also sometimes be that certain brands of drugs are out of stock and people may have to switch to another brand or different drug. In the worst case someone may have a period of time without the medication, a drug which could help reduce the risk of their breast cancer coming back or spreading.” Read full story Source: The Guardian, 14 January 2024 -
Content ArticleTOXBASE is the poisons information database created and maintained by the National Poisons Information Service (NPIS). It should be the first port of call for healthcare professionals seeking poisons information in the UK. NHS facilities can register for free and individual advice on more serious or complex cases is available via the NPIS 24-hour telephone service.
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Content ArticleMedication is a common cause of preventable medical harm in paediatric inpatients. This study aimed to examine the sociotechnical system surrounding paediatric medicines management and to identify potential gaps in this system and how these might contribute to adverse drug events (ADEs). The authors advocate the following actions as a result of the insights gained about contributing factors to ADEs: processes to involve parents in the care of their children in hospital. development of skill-mix interventions to ensure appropriate expertise is available where it is needed. modified checking procedures to permit staff to use their skills and judgment effectively and efficiently.
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Content ArticleThe Parkinson’s Excellence Network has launched three new practical guides to support UK health professionals to deliver time critical Parkinson’s medication on time in hospital.
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Event
A practical guide to Human Factors in healthcare
Sam posted an event in Community Calendar
Aimed at Clinicians and Managers, this national virtual conference will provide a practical guide to human factors in healthcare, and how a human factors approach can improve patient care, quality, process, and safety. The conference delves into integrating human factors into healthcare systems and processes, clinical decision making, healthcare system design, quality of patient experience, medication safety, and workload, fatigue, and stress management. Throughout the day, there will be interactive sessions, small breakout groups, and collaborative exercises, fostering a dynamic learning experience. For further information and to book your place visit https://www.healthcareconferencesuk.co.uk/virtual-online-courses/a-practical-guide-to-human-factors-in-healthcare or email kate@hc-uk.org.uk hub members receive a 20% discount. Email info@pslhub.org for discount code. Follow on Twitter @HCUK_Clare #HumanFactors -
Content ArticleReckitt has taken the precautionary step of recalling Nutramigen LGG stage 1 and stage 2 Hypoallergenic Formula powders because of the possible presence of Cronobacter sakazakii. Both products are foods used for special medical purposes for infants. The products are mainly prescribed but are also available without a prescription. Symptoms caused by Cronobacter sakazakii usually include fever and diarrhoea, and in severe cases may lead to sepsis or meningitis which include symptoms in infants including poor feeding, irritability, temperature changes, jaundice (yellow skin and whites of the eyes) and abnormal breaths and movements. Read Reckitt's recall notice
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News Article
Prescription drugs sold online without robust checks
Patient Safety Learning posted a news article in News
Patients' lives are being put at risk because it is too easy to buy prescription-only medicines from online pharmacies, a leading pharmacist says. A BBC investigation found 20 online pharmacies selling restricted drugs without checks - such as GP approval. In total, over 1,600 various prescription-only pills were bought during the investigation entering false information without challenge. Regulator the General Pharmaceutical Council says extra checks are needed when selling some drugs online. The BBC's findings highlight the "wild west" of buying medicines on the web, says Thorrun Govind, a pharmacist, health lawyer and former chair of the Royal Pharmaceutical Society. "The current guidance basically tells pharmacies to be robust, but do that in your own way, and we know that under this current system, patients have died," she says. The parents of a woman who died in 2020, after accidentally overdosing on medicines she bought online, are among those calling for stricter rules. Katie Corrigan, from St Erth in Cornwall, had developed an addiction to painkillers after experiencing neck pain. "Katie needed help, she didn't need more medication," says her mum, Christine Taylor. Her GP had stopped supplying the drug after realising she had been allowed to request new prescriptions prematurely and been prescribed too much. Instead, Katie, 38, was able to buy a painkiller and a drug used to treat anxiety from multiple online pharmacies without notifying her GP. The coroner at Katie's inquest confirmed her GP had not been contacted by any of the pharmacies to check the drug was safe for her. In his final report, he said the safety controls were inadequate. Read full story Source: BBC News, 5 January 2024 -
Content ArticleInterprofessional communication is of extraordinary importance for patient safety. To improve interprofessional communication, joint training of the different healthcare professions is required in order to achieve the goal of effective teamwork and interprofessional care. The aim of this pilot study from Heier et al. published in BMC Medical Education was to develop and evaluate a joint training concept for nursing trainees and medical students in Germany to improve medication error communication.
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Content ArticleAntimicrobial agents, such as antibiotics, are essential to treat some human and animal infectious diseases. Antimicrobial resistance (AMR) occurs when microorganisms change so that they are no longer affected by antimicrobial drugs used to treat them. There are different types of antimicrobials, which work against different types of microorganisms, such as antibacterials or antibiotics against bacteria, antivirals against viruses, and antifungals against fungi. Antimicrobials are often used incorrectly. The development of resistance is accelerated by the inappropriate use of these drugs, for example, using antibiotics (which help to treat bacteria) for viral infections like flu, or as a growth promoter in agriculture. Because of growing resistance, the world is running out of effective antibiotics to treat infectious diseases. Unless appropriate action is taken, decades of progress in health and medicine risk being undone. In May 2015, the World Health Assembly (WHA) endorsed a global action plan on AMR and urged all WHO Member States to develop national action plans (NAPs). The Seventy-third session of the WHO Regional Committee for Europe launched the new European roadmap on AMR (2023–2030) to help accelerate the implementation of national strategies on AMR. The new brief from WHO Regional Office for Europe highlights the important connections between AMR infection prevention and control.
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Content ArticleThe US Food and Drug Administration (FDA) list of drug names with recommended tall man (mixed case) letters was initiated in 2001 with the agency’s Name Differentiation Project. Tall man lettering (TML) is a technique that uses uppercase lettering to help differentiate look-alike drug names. Starting on the left side of a drug name, TML highlights the differences between similar drug names by capitalizing dissimilar letters (e.g., vinBLAStine versus vinCRIStine and CISplatin versus CARBOplatin). TML can be used along with colour or bolding to draw attention to the dissimilarities between look-alike drug names, and alert healthcare providers that the drug name can be confused with another drug name. The Institute for Safe Medication Practices (ISMP) 'Look-alike drug names with recommended tall man (mixed case) letters' contains drug name pairs or larger groupings with recommended, bolded uppercase letters to help draw attention to the dissimilarities in look-alike drug names. The list includes mostly generic-generic drug names, although a few brand-brand or brand-generic names are included. See also our Medication error traps gallery
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Content ArticleThe opioid epidemic has been declared a public health emergency in the US, with major news outlets calling operating rooms “unintended gateways.” In response to this emergency, a team from Thomas Jefferson University sought to decrease their organisation's contribution to the potential diversion pool—the opioids surgeons prescribe to patients which go unused. This article in the journal Patient Safety looks at the research and improvement work undertaken by the team, who concluded that surgical departments can develop opioid reduction toolkits aimed at reducing the potential diversion pool of opioids in communities.
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Content ArticleThis article in The Lancet looks at the need to prioritise palliative care and medications during armed conflict. The authors argue that the Israel–Hamas conflict amplifies the dire need for access to morphine and other essential palliative care medicines included on WHO's Model Lists of Essential Medicines in order to alleviate serious health-related suffering during humanitarian crises. They outline calls that the global palliative care community has made to the World Health Organization (WHO) and other aid organisations to: add adequate oral and injectable morphine and other pain-relieving medicines in humanitarian aid response packages ensure adequate essential medicine supplies for surgery and anaesthesia provide guidelines on the safe use of essential medicines and their distribution to all aid and health workers collaborate with receiving authorities to prevent removal of controlled medicines from emergency kits include paediatric essential medicine formulations for children. They argue that opioids and other essential palliative care medicines equip health workers with the means to relieve serious health-related suffering across clinical scenarios when curative or life-saving interventions are unavailable.
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Content ArticleThe evidence presented in this report makes the undeniable case that people living with a mental health condition and taking medicines need better access to the expertise of pharmacists across the whole spectrum of care.
