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Content ArticleSharon Hartles is a critical criminologist and member of the Open University’s Harm and Evidence Research Collaborative. In this article, Sharon reflects on the significant impact of the harm caused by Primodos, a widely used hormone pregnancy test prescribed to women in the UK between 1958 and 1970. Primodos is now known to cause miscarriage, stillbirth and birth defects, and this article examines the culture of denial and an absence of state and corporate pharmaceutical accountability that allowed patients to continue to be harmed over decades.
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Content ArticleThis guidance from the British Medical Association (BMA) covers frequently asked questions around prescribing in primary care and informs GPs of the BMA general practice committee’s policies in prescribing.
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Content ArticleThis study in the British Journal of General Practice aimed to examine trends in prescribing for anxiety in UK primary care between 2003 and 2018. Anxiolytic drugs are a group of medications used to relieve anxiety. The authors analysed data from 2.5 million adults to determine prevalence, incidence rates and treatment duration for prescriptions of any anxiolytic, and also for each drug class. The authors found that, between 2003 and 2018: prevalence of any anxiolytic prescription increased, driven by increases in those starting treatment, rather than more long-term use. incident beta-blocker prescribing increased over the 16 years, whereas incident benzodiazepine prescriptions decreased. long-term prescribing of benzodiazepines declined, yet 44% of prescriptions in 2017 were longer than the recommended four weeks. incident prescriptions in each drug class have risen substantially in young adults in recent years. They conclude that increases in incident prescribing may reflect better detection of anxiety or increasing acceptability of medication. However, they also caution that prescribing approaches may cause unintended harm, as some prescribing is not based on robust evidence of effectiveness and may contradict guidelines. They highlight that there is limited evidence on the overall impact of taking antidepressants long term.
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Content ArticleMedication errors are any Patient Safety Incidents (PSI) where there has been an error in the process of prescribing, preparing, dispensing, administering and monitoring or providing advice on medicines. From 1 April 2015 until 31 March 2020 NHS Resolution received 1420 claims relating to medication errors. This leaflet from NHS Resolution analyses closed claims that have been settled with damages paid and concern an element of the medication process: prescribing, transcribing, dispensing, administering and monitoring.
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Content ArticleThis customisable, educational toolkit published by the Agency for Healthcare Research and Quality (AHRQ) aims to help ICUs reduce rates of central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). The materials can be used to assess current safety practice, implement new approaches and overcome particular challenges related to CLABSI and CAUTI in ICUs.
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Content ArticlePatient safety alerts are issued to providers of NHS care to support them to take specific actions to keep patients safe. Although some content of past alerts is outdated, some of the actions from previously issued alerts continue to be relevant and remain valid beyond the timescales of the original alert. Over 140 alerts issued up to November 2019 (including ‘notices’ or ‘rapid response reports’) were recently clinically reviewed to identify which actions within those alerts remain valid and should be considered as ‘enduring standards’. The review covered alerts issued by the NHS England and NHS Improvement National Patient Safety Team and its predecessor organisation, the National Patient Safety Agency (NPSA). The review also summarised other content from the alerts identified as general principles that can be applied more widely to inform wider ongoing safety improvement. The key elements from the review are highlighted. The pages do not set out any new actions for organisations to implement, but act as an aid to support providers to confirm that ‘enduring standards’ from previously completed alerts have been embedded locally, and that the general principles are considered within ongoing patient safety improvement.
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Content ArticlePotassium permanganate is routinely used in the NHS as a dilute solution to treat weeping and blistering skin conditions, such as acute weeping/infected eczema and leg ulcers. It is not licensed as a medicine. Supplied in concentrated forms, either as a ‘tablet’ or a solution, it requires dilution before it is used as a soak or in the bath. These concentrated forms resemble an oral tablet or juice drink and if ingested are highly toxic; causing rapid swelling and bleeding of the lips and tongue, gross oropharyngeal oedema, local tissue necrosis, stridor, and gastrointestinal ulceration. Ingestion can be fatal due to gastrointestinal haemorrhage, acute respiratory distress syndrome and/or multiorgan failure. Even dilute solutions can be toxic if swallowed. A Patient Safety Alert issued in 20142 highlighted incidents where patients had inadvertently ingested the concentrated form, and the risks in relation to terminology and presenting tablets or solution in receptacles that imply they are for oral ingestion, such as plastic cups or jugs. A review of the National Reporting and Learning System over a two-year period identified that incidents of ingestion are still occurring. One report described an older patient dying from aspiration pneumonia and extensive laryngeal swelling after ingesting potassium permanganate tablets left by her bedside. Review of the other 34 incidents identified key themes: healthcare staff administering potassium permanganate orally patients taking potassium permanganate orally at home, or when left on a bedside locker potassium permanganate incorrectly prescribed as oral medication. The British Association of Dermatologists (BAD) ‘Recommendations to minimise risk of harm from potassium permanganate soaks’ includes advice on formulary management, prescribing, dispensing, storage, preparation and use, and waste.
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Content ArticleThis report by Save the Children's Global Medical Team (GMT) shares the results of independent audits conducted in 2021. The audits aimed to assess the safety and quality of clinical and pharmacy services delivered by the organisation across seven countries. The team strategically focused on higher-risk programmes where Save the Children staff deliver services directly, with an aim to ensure that services remain safe and fully assured.
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Content ArticleIn this video, Dr Zubin Damania discusses the recent criminal conviction of US nurse RaDonda Vaught for a medical error and why this is terrible for patient safety, moral and the future of nursing and medicine.
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Content ArticleThe Patient Safety Movement are looking for patients, family members, health workers and administrators to reach out if they have an experience related to harm or death due to a medication error in the operating room. While the specific numbers may be debated, that medication errors, while rare in the operating, could have catastrophic consequences. The Patient Safety Movement are interested in hearing your perspective concerning this issue. Please email events@patientsafetymovement.org if you have a story that you’d like to share. If you are worried about anonymity please submit your story at the link below.
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Content ArticleRaDonda Leanne Vaught faced criminal charges over a fatal medication error she made in 2017. Her trial has raised important questions over medical errors, reporting and process improvement, as well as who bears responsibility for widespread use of tech overrides in hospitals. There is debate over whether automated dispensing cabinet overrides are a reckless act or institutionalised as ordinary given the widespread use of IT workarounds among healthcare professionals. The Nashville District Attorney's Office described this override as a reckless act and a foundation for Ms. Vaught's reckless homicide charge, while some experts have said cabinet overrides are used daily at many hospitals.
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Content ArticleThis blog provides an overview of a roundtable webinar organised by the European Biosafety Network (EBN), which focused on the need to prevent exposure to hazardous medicinal products (HMPs) and other substances. It was chaired by Gitta Vanpeborgh, Belgian Federal Deputy, and included attendees from across Europe.
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This is part of our new series of Patient Safety Spotlight interviews, where we talk to people about their role and what motivates them to make health and social care safer. Roohil talks to us about the vital role of pharmacists in making sure medications help patients, rather than causing harm. She highlights the global threat of substandard and counterfeit medicines, the need to improve access to medicines and the importance of having pharmacists 'on the ground' to help patients understand how to take them. -
Content ArticleThis study in the British Journal of General Practice aimed to identify cardiovascular disease-related Prevention of Future Deaths reports (PFDs) involving anticoagulants, and to highlight issues raised and responses received. The authors highlight that nearly two-thirds (60%) of PFDs had not received responses from the organisations they were sent to, including NHS trusts, hospitals and general practices. They call for national organisations, healthcare professionals and prescribers to take actions that address concerns raised by coroners in PFDs, in order to improve the safe use of anticoagulants in treating cardiovascular disease.
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In this blog Patient Safety Learning’s Chief Executive, Helen Hughes, discusses the connection between procurement, supply chains and patient safety, ahead of an upcoming Safety for All Campaign webinar on this topic. -
Content ArticleMedication errors are the most common adverse event in hospitals and have significant economic and health consequences. This white paper developed by the European Collaborative Action on Medication Errors and Traceability (ECAMET) Alliance collects the results of a pan-European survey on medication errors. It includes 25 reports comprising 13 country reports in English, eight translations in other languages, a private hospitals report, specialised oncology and ICU reports and one consolidated report. It makes several recommendations to reduce medication errors in hospitals and highlights the need to: establish a culture of safety. create strategies to improve communication. raise awareness and organise regular multi-disciplinary training meetings. systematically use accreditation/certification systems. introduce technological tools.
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Content ArticleMedication errors harm patients and cost the NHS money – but with the right approach they can be significantly reduced. An HSJ article with Patrick Wilkinson and Nick Rodger from BD.
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Content ArticleThis guide by the non-profit organisation US Pharmacopeia highlights the global challenge of substandard and falsified Covid-19 vaccines and the impact this has on individuals, the ability to control the pandemic, larger societal health, public trust and social justice. It outlines strategies to help prevent, detect and respond to substandard and falsified vaccines, in line with existing World Health Organization processes.
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Content ArticleThe cornerstone of good general practice has long been recognised as lying in the quality of the relationship between doctor and patient. This focus on the interaction between GP and patient has been further reinforced in recent years by increasing attention on the patient’s experience of healthcare encounters. However, pleasing the patient is not always consistent with providing good-quality care. GPs are well aware that patients may demand an antibiotic when it is not judged clinically appropriate. The aim of this study from Ashworth et al. was to determine the relationship between antibiotic prescribing in general practice and reported patient satisfaction. The results found that patients were less satisfied in practices with frugal antibiotic prescribing. A cautious approach to antibiotic prescribing may require a trade-off in terms of patient satisfaction.
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Content ArticleAs the global population ages, more people are likely to suffer from multiple long term illnesses and therefore take multiple medications. This report by the World Health Organization highlights the importance of leadership in nurturing a culture that prioritises safe, high-quality prescribing, provides guidance on medication review, and emphasises the role of the patient in prescribing decisions. It also examines the role of multi-professional teams across the healthcare system, including amongst policy makers. The report includes tools and case studies which illustrate a systematic approach that can be followed across the health and care system to ensure that patients are integral to the decisions about their medications.
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The third WHO Global Patient Safety Challenge: Medication Without Harm proposes solutions to address obstacles to safe medication practices. WHO aims to achieve widespread engagement and commitment of WHO Member States and professional bodies around the world to reducing the harm associated with medication. This Strategic Framework of the Global Patient Safety Challenge depicts the four domains of the Challenge: patients and the public, health care professionals, medicines and systems and practices of medication. The framework describes each domain through four subdomains. The three key action areas – polypharmacy, high-risk situations and transitions of care – are relevant in each domain and therefore form an inner circle. -
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WHO medsafe app
Patient-Safety-Learning posted an article in Medication
The World Health Organization has released a mobile application for patients and their families and caregivers as part of its Global Patient Safety Challenge: 'Medication Without Harm'. The app is designed to guide patients through the five key moments where action can reduce the risk of medication-related harm, and to facilitate patients to ask their healthcare professional important questions about their medications. The app is available from Google Play and the Apple App Store. -
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Belfast Healthy Cities: Pharmacy Schools Programme (2021)
Patient-Safety-Learning posted an article in Medication
The Pharmacy Schools Programme is an innovative teaching resource developed by Belfast Healthy Cities. Using a health literacy approach, it is designed to be used in primary schools in Northern Ireland to help educate children about self-care, medication safety and community pharmacy services. -
Content ArticleThis document sets out the Northern Ireland Department of Health's ambitions to improve medication safety in Northern Ireland, in line with the World Health Organization's Third Global Patient Safety Challenge 'Medication without Harm'. It outlines the need for safer use of medicines in Northern Ireland and highlights four ways in which the Department for Health will address these challenges: Engagement with patients and the public Introducing new systems and practice Engagement and training of health and social care staff Reducing the burden of avoidable harm from high-risk medicines by building good practice in to the supply of all medications
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Content ArticleThis article in the British Journal of Clinical Pharmacology aimed to calculate the medication costs of potentially inappropriate prescribing for middle-aged adults compare with the cost of consensus-validated, evidence-based, ‘adequate’ alternative prescribing scenarios. It used a Delphi consensus panel and cross-sectional study to examine primary care data of 55,880 patients aged 45-64 years old in South London. The study found that duplicate drug classes was the most costly criterion for both PIP and alternative prescribing. It identified no substantial cost difference between adequate prescribing versus PIP and the authors recommend that future studies investigate the wider health economic costs of alternative prescribing, such as reducing hospital admissions.
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