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Content Article
Medication safety: "Know Check Ask"
Claire Cox posted an article in Resources for patients
Do 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? Keeping track of your medicines and communicating about them can be tricky as there can be so many details to remember. This is especially important if you have a healthcare appointment or are going to hospital. This "Know Check Ask" campaign website is here to help. Please click on the content below to learn more about taking medicines safely. -
Content Article
Medicines safety: NHS online learning index
Claire Cox posted an article in Medication including labelling
This alphabetical index helps NHS staff with an interest in the safe use of medicines to quickly find e-learning or videos that have already been produced by the NHS, government agencies, or professional bodies. -
Content Article
Antibiotic Resistance & Patient Safety Portal
Claire Cox posted an article in International patient safety
The Antibiotic Resistance & Patient Safety Portal (AR&PSP) is an interactive web-based application that was created to innovatively display data collected through CDC’s National Healthcare Safety Network (NHSN), the Antibiotic Resistance Laboratory Network (AR Lab Network), and other sources. It offers enhanced data visualizations on Antibiotic Resistance, Use, and Stewardship datasets as well as Healthcare-Associated Infection (HAI) data. -
Content ArticleThis YouTube video from nurse, Sophie Pig, aims to give you a better understanding of the 7 rights of medication administration. It is important to remember these 'rights' for every patient you encounter on a drug round.
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Content ArticleThe purpose of this study, published in the European Journal of Hospital Pharmacy, was to ascertain the views, beliefs and attitudes of hospital staff to incorrect penicillin allergy records in order to determine healthcare worker motivation for the implementation of a penicillin de-labelling antibiotic stewardship intervention at the study hospital. Findings showed that virtually all staff in this study, had encountered patients who believed themselves to be penicillin allergic, but felt the patient’s belief to be erroneous. Therefore, a penicillin allergy de-labelling intervention might be of benefit to ensure that patients who were not allergic were able to have the correct antibiotic.
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Content ArticleAntibiotics are key to modern medicine and treatment. Many procedures and treatments developed over recent years, such as chemotherapy, organ transplants and other major surgery, rely on antibiotics to prevent infections. They are also crucial in treating some forms of pneumonia and other illnesses. However, an increasing number of common infections are becoming resistant to the drugs designed to treat them. This is called antimicrobial resistance (AMR). Antimicrobial stewardship (AMS) is part of the fight against AMR. The purpose of AMS is to ensure ‘the right antibiotic for the right patient, at the right time, with the right dose, and the right route, causing the least harm to the patient and future patients’. AMS programmes might include improving prescribing of antibiotics, promoting data collection and raising public awareness of AMR.
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Content ArticleThe government-commissioned review, First Do No Harm, into why mesh implants and other treatments were allowed to harm hundreds of women said the failings were “caused and compounded by failings in the health system itself”. HSJ's Health Check podcast considers why it is being buried by government.
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Content ArticleOn Wednesday 8 July 2020 the Independent Medicines and Medical Devices Safety Review published its report First Do No Harm, examining how the healthcare system in England responds to reports about the harmful side effects from medicines and medical devices. Chaired by Baroness Julia Cumberlege, the review focused on looking at what happened in relation to three medical interventions: hormone pregnancy tests, sodium valproate and pelvic mesh implants. In this blog Patient Safety Learning consider the reports findings in more detail, highlighting the key patient safety themes running through this, which are also found in many other patient safety scandals in the last twenty years. It also looks at what needs to change to prevent these issues recurring and asks whether NHS leaders stick with the current ways of working, make a few improvements, or take this opportunity for transformational change.
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Content ArticleThe objective of this systematic review from Kuitunen et al., in the Journal of Patient Safety, was to identify systemic defenses (such as barcode scanning) to confirm drug and patient identity, clinical decision systems, and smart infusion pumps) to prevent in-hospital intravenous (IV) medication errors. Of the 46 included studies, most discussed systemic defenses related to drug administration; fewer discussed defenses during prescribing, preparation, treatment monitoring and dispensing. Closed loop medication management and smart pumps were the most common systemic defenses examined in the included studies The authors identify a need for further studies exploring the effectiveness of different combinations of systemic defenses.
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Content ArticleUser-testing and subsequent modification of clinical guidelines increases health professionals’ information retrieval and comprehension, but no study has investigated whether this results in safer care. Jones et al. compared the frequency of medication errors when administering an intravenous medicine using the current National Health Service Injectable Medicines Guide (IMG) versus an IMG version revised with user-testing. Participants were on-duty nurses/midwives who regularly prepared intravenous medicines. Using a training manikin in their clinical area, participants administered a voriconazole infusion, a high-risk medicine requiring several steps to prepare. They were randomised to use current IMG guidelines or IMG guidelines revised with user-testing.
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Content ArticleThis Review was announced in the House of Commons on 21 February 2018 by Jeremy Hunt, the then Secretary of State for Health and Social Care. Its purpose is to examine how the healthcare system in England responds to reports about harmful side effects from medicines and medical devices and to consider how to respond to them more quickly and effectively in the future. The Review was asked to investigate what had happened in respect of two medications and one medical device: hormone pregnancy tests (HPTs) – tests, such as Primodos, which were withdrawn from the market in the late 1970s and which are thought to be associated with birth defects and miscarriages; sodium valproate – an effective anti-epileptic drug which causes physical malformations, autism and developmental delay in many children when it is taken by their mothers during pregnancy; and pelvic mesh implants – used in the surgical repair of pelvic organ prolapse and to manage stress urinary incontinence. Its use has been linked to crippling, life- changing, complications; and to make recommendations for the future. The Review was prompted by patient-led campaigns that have run for years and, in the cases of valproate and Primodos over decades, drawing active support from their respective All-Party Parliamentary Groups and the media.
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Content Article
The Salford Medication Safety Dashboard (SMASH)
Claire Cox posted an article in Medication administration
The Salford Medication Safety Dashboard (SMASH) was successfully used in general practices with the help of on-site pharmacists. SMASH is a web application that flags up a list of patients who are potentially at risk from medicines they have been prescribed. -
Content ArticleDouble checking medication administration in hospitals is often standard practice, particularly for high-risk drugs, yet its effectiveness in reducing medication administration errors (MAEs) and improving patient outcomes remains unclear. This systematic review of studies, published in BMJ Quality & Safety, evaluates evidence of the effectiveness of double checking to reduce MAEs.
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Content ArticleThe aim of the Patient Safety and Access Initiative of India Foundation is to improve accessibility to safe and quality healthcare for all under Universal Health Coverage (UHC) and tackling the menace of spurious and not of standards medicines in the supply chain globally.
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Content ArticlePrimary care services provide an entry point into the health system which directly impact's people well-being and their use of other healthcare resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organization (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, the majority of the work has been focused on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. The paper from Kuriakose et al., published in the Journal of Family Medicine and Primary Care, focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.
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Content Article
Over-diagnosis and over-treatment in the frail elderly (November 2019)
Claire Cox posted an article in Older people
Frailty is increasingly recognised as a critically important policy and quality of care issue in healthcare systems. There is clear evidence that frail older people are at increased risk of acute illness. These heightened risks mean that frailty is associated with high mortality and high healthcare utilisation. It is a key consideration in clinical decision-making. However, frailty is a contested concept, both in definition and measurement terms. Identification of frailty is complex and issues of over-diagnosis and over-treatment are increasingly garnering attention. -
Content ArticleChildren admitted to paediatric and neonatal intensive care units may be at high risk from medication errors (MEs) and preventable adverse drug events. In this systematic review published in Drug Safety, Alghamdi et al., reviewed empirical studies examining the prevalence and nature of MEs and preventable adverse drug events in paediatric and neonatal intensive care units. They found that medication errors occur frequently in critically ill children admitted to paediatric and neonatal intensive care units and may lead to patient harm. Important targets such as dosing errors and anti-infective medications were identified to guide the development of remedial interventions.
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Content ArticleIn this study published in the Quality Management in Healthcare journal, a community health organisation’s successful method of frontline staff committee engagement generated process changes that culminated in reduced medication errors and increased near misses. Continuous quality improvement initiatives supported by these committees included technical handling and administration of medication, medication reconciliation, and enhancements to standardised treatment protocols.
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Content ArticlePrescription drug errors are a leading source of harm in health care, resulting in substantial morbidity, mortality and healthcare costs estimated at more than $20 billion annually in the US. Currently, clinical decision support (CDS) alerting tools – computerised alerts and reminders – are widely used to identify and reduce medication errors. However, CDS systems have a variety of limitations, including that they are rule based and can identify only medication errors that have been previously identified and programmed into the alerting logic. A new study from Rozenblum et al., published in The Joint Commission Journal on Quality and Patient Safety, used retrospective data to evaluate the ability of a machine learning system – a platform that applies and automates advanced machine learning algorithms – to identify and prevent medication prescribing errors not previously identified by and programmed into the existing CDS system.
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Content ArticleA recent report from the Healthcare Safety Investigations Branch, Investigation into electronic prescribing and medicines administration systems and safe discharge, highlighted the fact that poorly implemented ePMA (electronic prescribing and medicines administration) systems can result in potentially fatal medication errors. The report focused on the death of 75 year-old Mrs Ann Midson, following a medication error. In this podcast interview, Pharmacy in Practice speaks to Scott Hislop and Helen Jones, two of the investigators, to discuss the series of events that ultimately culminated in the sad passing of Mrs Ann Midson.
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Content ArticleHarold Shipman was an English doctor who killed approximately 15 patients while working as a junior hospital doctor in the 1970s, and another 235 or so when working subsequently as a general practitioner. Is it possible to learn general lessons to improve patient safety from such extraordinary events? In this paper, published in the US Journal of the Royal Society of Medicine, it is argued that it is not possible fully to understand how Shipman came to be such a successful and prolific serial killer, nor to learn how the safety of healthcare systems can be improved, unless his diabolical activities are studied using approaches developed to investigate patient safety.
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Content ArticleThe Healthcare Safety Investigation Branch (HSIB) recently published a report that highlighted the fact that poorly implemented ePMA (electronic prescribing and medicines administration) systems can result in potentially fatal medication errors. The report comes after HSIB looked at the case of 75-year old Ann Midson, who was left taking two powerful blood-thinning medications after a mix-up at her local hospital where she was receiving treatment whilst suffering from incurable cancer. PRAC+TICE caught up with Scott Hislop and Helen Jones, two of the investigators, on this podcast to discuss the series of events that ultimately culminated in the sad passing of Mrs Ann Midson.
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Content ArticleThere are an estimated 200,000 severe adverse drug errors (ADRs) in Canada each year, though it is estimated that 95% of ADRs are not reported. They cost the Canadian healthcare system between $13.7 and $17.7 billion each year and kill up to 22,000 Canadians each year. Over 5,000 of these are Canadian children. ADR Canada is working to prevent this. This article explains the role of genomics in the solution to adverse drug reactions.
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Content ArticleSince the emergence of the opioid epidemic in the United States at the beginning of the 21st century, more than 400,000 Americans have died as the result of an opioid overdose. As of 2018, the Substance Abuse and Mental Health Services Administration estimates that more two million people have an opioid use disorder. With the rate of opioid-related inpatient stays and the number of opioid-related emergency department visits continuing to rise dramatically in the US, hospitals have the opportunity to make a major impact in reducing morbidity and mortality related to opioid use. This document, produced by the Institute for Healthcare Improvement, provides system-level strategies that hospitals can implement immediately to address the challenges of preventing, identifying, and treating opioid use disorder.
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Content ArticleNeptune's Dr Catherine Massey, Clinical Director, and Sophie Britt, Lead Trainer, tell us about their initiative and the difference it has made to patient safety and how it felt to win a Patient Safety Learning Award. They also discuss what they plan to do next. View video
