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EventuntilThe International Alliance of Patients’ Organizations (IAPO) and Patient Academy for Innovation and Research (PAIR Academy) in partnership with Dakshama Health are launching a series of webinars to introduce the Strategic Framework of the Global Patient Safety Challenge - Medication Without Harm. The theme of the 6th webinar of the medication without harm webinar series is "Medication Safety in Polypharmacy and Transitions of Care”. Register for the webinar The patient safety series of webinars will focus on the strategic framework of the Global Patient Safety Challenge, which depicts the four domains of the challenge: patients and the public, health care professionals, medicine, and systems and practices of medication, and the three key action areas—namely polypharmacy, high-risk situations, and transitions of care, The series of webinars will share challenges, technical strategies, tools, and patient experiences in implementing the Strategic Framework of the Global Patient Safety Challenge to reduce medication-related harm.
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Content ArticleEach year, 7,000 to 9,000 people die as a result of a medication errors in the US, and the total cost of looking after patients with medication-associated errors exceeds $40 billion. Alongside this financial cost, adverse events caused by medication errors also cause patients significant psychological and physical pain and suffering. The article aims to: identify the most common medication errors. review some of the critical points at which medication errors are most likely to occur. outline strategies to prevent medication errors occurring. summarise multidisciplinary team strategies for decreasing medication errors.
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Community PostIn unit-dose dispensing, medication is dispensed in single doses in packages that are ready to administer to the patient. It can be used for medicines administered by any route, but oral, parenteral, and respiratory routes are especially common. The system provides a fully closed loop process where the patient, the drug and the healthcare professional are identified by machine readable codes and the drug administration process is linked directly to the electronic prescription. and is fully recorded There are many variations of unit-dose dispensing. As just one example, when physicians write orders for inpatients, these orders are sent to the central pharmacy . Pharmacists verify these orders and technicians place drugs in unit-dose carts. The carts have drawers in which each patient's medications are placed by pharmacy technicians—one drawer for each patient. The drawers are labelled with the patient's name, ward, room, and bed number. Sections of each cart containing all medication drawers for an entire nursing unit often slide out and can be inserted into wheeled medication carts used by nurses during their medication administration cycles. Alternatively, electronic medicine storage cabinets can be located on wards and these are attached to medicine carts which are then filled from the cabinets. Studies often compare unit-dose dispensing to a ward stock system. In this system, bulk supplies are issued from the pharmacy; the drugs are stored in a medication room on the ward. The correct number of doses must be taken out of the correct medication container for each cycle and taken to the patient for administration. Liquids must be poured by the nurse from the appropriate bottle and each dose carefully measured. Evidence for Effectiveness of the Practice Though the practice of unit-dose dispensing is generally well accepted and has been widely implemented, the evidence for its effectiveness is modest. Most of the published studies reported reductions in medication errors of omission and commission with unit-dose dispensing compared with alternative dispensing systems such as ward stock systems. Potential for Harm Unit-dosing shifts the effort and distraction of medication processing, with its potential for harm, from the ward to central pharmacy. It increases the amount of time nurses have to do other tasks but increases the volume of work within the pharmacy. Like the nursing units, central pharmacies have their own distractions that are often heightened by the unit-dose dispensing process itself, and errors do occur. Overall, unit-dose appears to have little potential for harm. The results of most of the observational studies seem to indicate that it is safer than other forms of institutional dispensing. However, the definitive study to determine the extent of harm has not yet been conducted. A major advantage of unit-dose dispensing is that it brings pharmacists into the medication use process at another point to reduce error. Yet about half of the hospitals in a national survey indicated that they bypass pharmacy involvement by using floor stock, borrowing patients' medications, and hiding medication supplies. Unit dose drug distribution is being introduced across Europe. In Germany, a recent study showed a saving of 2.61 WTE nurses per 100 beds. There is now growing interest in UK hospitals and pilot sites to develop the system are being established.
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Content ArticleThis open letter from the Pharmacists' Defence Association (PDA) raises concerns about unnecessary full or part-day closures of community pharmacies throughout the UK by some large multiple pharmacy operators. The letter states that these operators are telling patients and the government that they have been unable to find pharmacists, citing an alleged national pharmacist shortage. However, the PDA's members report that this is not the case, and the letter draws attention to closures being planned four weeks in advance, and to locum pharmacists having agreed rates of pay reduced at the last minute. The PDA highlights the risk to patient safety caused by these closures, and calls for more regulatory action to be taken by the government and other regulators. The letter is addressed to: Government Health Secretaries of England, Northern Ireland, Scotland and Wales Chief Executives of the National Health Service in England, Northern Ireland, Scotland and Wales NHS Chief Pharmaceutical Officers for England, Northern Ireland, Scotland and Wales Chief Executive of General Pharmaceutical Council and Pharmaceutical Society of Northern Ireland.
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Content ArticleThis article discusses how medication safety can be improved in Canada. It explores the complexities of aging, what can go wrong with medication, 'Best Possible Medication Histories', the role of pharmacists and paramedics, engaging with patients and their families, and improving communication across the healthcare system.
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Content ArticlePharmacists and pharmacy technicians across different settings work hard to provide person-centred, safe and effective care to patients. But, in reality sometimes things go wrong. The way that professionals respond to these situations is key to supporting the people affected and improving patient safety for the future. This guidance from the General Pharmaceutical Council aims to provide you with guidance on how to implement the Duty of Candour.
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News Article
Boots criticised over pill boxes for the elderly
Patient Safety Learning posted a news article in News
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 -
EventuntilUnsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. WHO Patient Safety Flagship has initiated a series of monthly webinars on the topic of “WHO Global Patient Safety Challenge: Medication Without Harm”,. The main objective of the webinar series is support implementation of this WHO Global Patient Safety Challenge: Medication Without Harm at the country level. Considering the huge burden of medication-related harm, Medication Safety has also been selected as the theme for World Patient Safety Day 2022. Ensuring medication safety in polypharmacy is one of the critical challenges in medication safety. Inappropriate polypharmacy has been described as a significant public health challenge, as it increases the likelihood of adverse effects, considerably impacting health outcomes and expenditure on health care resources. Countries need to prioritize raising awareness of the problems associated with inappropriate polypharmacy and the need to address this issue. All stakeholders have a vital role in driving change for the management of polypharmacy. At this webinar, we will introduce the WHO technical report on “Medication Safety in Polypharmacy”, and experiences from different countries and organizations will be shared on the proper management of polypharmacy and the factors that influence appropriate polypharmacy. The session will be available in English, French and Spanish. Register for the webinar
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Content ArticleThe Pharmaceutical Journal speaks to formerly fit and well pharmacists and technicians whose lives have been devastated by Long Covid.
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News Article
High Street pharmacists to make cancer referrals
Patient Safety Learning posted a news article in News
People with a worrying cough, problems swallowing or blood in their urine will soon be able to be referred for scans and checks by a pharmacist, rather than having to wait to see their GP. The new pilot scheme, in England, aims to diagnose more cancers early, when there is a better chance of a cure. High Street pharmacies will be funded to refer customers for the checks. The NHS will also send out more "roaming trucks" to perform on-the-spot scans in the community. Lung-scanner vans driven to locations, including supermarket car parks and football stadiums, have already resulted in more people having checks. Now, some liver lorries will join them. Health and Social Care Secretary Sajid Javid said: "Ensuring patients can access diagnosis and treatment easily in their communities and on High Streets is a fundamental part of our 10-Year Cancer Plan." Dr Anthony Cunliffe, national clinical adviser for primary care, at Macmillan Cancer Support, said: "Doctors and nurses are working tirelessly to diagnose and treat the tens of thousands of people entering a very busy cancer care system. "This pilot will give people the opportunity to access more trained professionals in their community to get symptoms investigated." Read full story Source: BBC News, 15 June 2022 -
Content ArticlePharmacy teams may want to develop or implement new services in their organisations to realise quality, safety and operational benefits and financial efficiencies, or to improve the patient experience. The Pharmaceutical Journal highlights eight steps pharmacists should follow to ensure that a business case is as robust as possible.
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News Article
Law change to let pharmacists sign people off sick
Patient Safety Learning posted a news article in News
Pharmacists and some other healthcare professionals, rather than just GPs, will soon be able to sign people off sick from work, under new rules. The law change will take effect in July and apply across England, Wales and Scotland. The aim is to free up family doctors' time. People off work for more than seven consecutive days because of illness may need to show a note from a healthcare professional to their employer. When the new legislation is passed, nurses, occupational therapists, pharmacists (working in hospitals and GP practices) and physiotherapists will be able to provide the notes, in addition to GPs. Health and Social Care Secretary Sajid Javid said: "I know how important it is for people to be able to see their GP speedily and in the way they want. "That's why we are slashing bureaucracy to reduce GPs workloads, so they can focus on seeing patients and giving people the care they urgently need. Read full story Source: BBC News, 9 June 2022 -
News ArticlePharmacists say physical and verbal abuse against them has become unacceptably common and many now feel unsafe when at work. Police forces say they are being called out to handle pharmacy-based crimes. The Pharmacists' Defence Association (PDA) says there have been reports of a stabbing and physical attacks in pharmacies around the UK and that more needs to be done to enforce the NHS's zero tolerance policy on worker abuse.. Pharmacist Conor McAreavey was stabbed in the hand with a knife at his pharmacy in Belfast in March. He told the BBC he was "very lucky" not to have suffered tendon damage. Glasgow pharmacist Chand Kausar was threatened with a knife by an agitated patient, who - after demanding non-prescribed medication - produced a six-inch knife and cornered her against a wall. "I just froze," explains Ms Kausar. "My hands were above my head and I could hear all the noise around me, but I actually felt very calm. In my head all was quiet. I remember thinking it was like a movie scene. I'd never seen a knife like that, and I never imagined I'd have one held to my throat." The PDA launched an online survey in April 2022 and nearly 550 community pharmacists, mostly staff working in England, have responded so far. Some 468 of them - 85% - say they, or someone they work with, experienced verbal or racial abuse in the previous month while at work. One respondent said: "I feel terrified going to work every single day, and yet management are ignoring the issue." Read full story Source: BBC News, 6 June 2022
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News ArticleProposals for primary care networks to evolve into more collaborative “integrated neighbourhood teams” to improve access to care have been broadly welcomed. A “stocktake” report commissioned by NHS England, published on 26 May, called for urgent same day appointments to be dealt with by “single, urgent care teams” for every neighbourhood with greater use of a range of health and social care professionals. The report, written by Claire Fuller, a general practitioner and chief executive of Surrey Heartlands Integrated Care System, undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looks at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems. Doctors’ leaders welcomed many of the report’s recommendations but emphasised that they could only work if the government resourced primary care practices better and tackled workforce shortages. Read full story (paywalled) Source: BMJ, 27 May 2022
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Content ArticleThis is the final report of the stocktake undertaken by Dr Claire Fuller, Chief Executive-designate Surrey Heartlands Integrated Care System and GP on integrated primary care, looking at what is working well, why it’s working well and how we can accelerate the implementation of integrated primary care (incorporating the current 4 pillars of general practice, community pharmacy, dentistry and optometry) across systems.
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News Article
Pharmacies in Wales to help GPs prescribe medicines to patients
Patient Safety Learning posted a news article in News
Nearly a third of community pharmacies in Wales should be able to prescribe medicines for NHS patients, including antibiotics, by the end of this year, health officials say. It is the first new service of its kind in the UK. The aim is to take the pressure off GPs at a time of increasing strain on the NHS. Scotland has adopted a similar approach but England and Northern Ireland have not so far. Community pharmacies in Wales are allowed to offer prescriptions of medicines for acute illnesses such as urinary tract and respiratory infections, gout and chronic pain, as well as emergency contraception - if they have a pharmacist who has had extra training for prescribing. For most patients, that will be more convenient and avoid waits for GP appointments. The plan is to roll out the service progressively across Wales, building on local schemes already in place. Local doctors in general practice have welcomed the new policy. Dr Penny Coyle said each week about 25 patients with minor ailments were referred to the pharmacist, saving 100 GP appointments a month and giving doctors more time to visit seriously ill patients in their homes. "We are finding that demand is outweighing capacity and so anything that relieves some of the pressure on general practice is very welcome," she said. Association of Independent Multiple Pharmacies chief executive Dr Leyla Hannbeck said: "Pharmacist prescribers can help massively when you think about the shortages and the HRT issues, for example, that we are currently facing - having a pharmacist prescriber being able to prescribe alternative medicines without the patient having to wait to see the GP." Read full story Source: BBC News, 27 April 2022 -
Content ArticleThe Community Pharmacy Patient Safety Group conducted this anonymous survey on patient safety culture in Autumn 2021 and invited pharmacy staff from across the UK to participate. The aim of the survey was to understand patient safety practice from the perspective of frontline pharmacy teams. Both the full results and an infographic of key results are available to download.
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News Article
Pharmacists in England face abuse from patients due to drug shortages
Patient Safety Learning posted a news article in News
Pharmacy staff in England are facing growing abuse and aggression from patients frustrated that drug shortages mean they cannot get their usual medications, a survey reveals. The hostility, including swearing and spitting, comes as availability of medicines is becoming more uncertain as a result of Brexit, the Covid pandemic and ingredient supply problems. Hormone replacement therapy drugs are in short supply in many places, affecting women undergoing menopause, for example. Half of pharmacists and counter staff say the unpredictability is causing problems for customers managing their health, according to research by the Pharmaceutical Services Negotiating Committee (PSNC), which represents community pharmacies in England. The PSNC’s survey of 1,132 staff from and 418 bosses of 5,000 pharmacies found: 75% of pharmacies have seen patients turn aggressive when told they cannot have the medication they have been prescribed. 49% of staff say patient abuse is undermining their mental wellbeing. 51% believe supply chain issues affect patients every day. “It is really worrying to hear that pharmacy staff are so routinely facing aggression from patients,” said Janet Morrison, the PSNC’s chief executive. “Pharmacists tell us anecdotally that this can include verbal abuse, swearing, spitting and threatening to report staff to regulators. “Many community pharmacies are having to deal with medicine supply issues on a daily basis. This adds pressures on to already busy pharmacy teams and can also be worrying for patients if they have to wait longer for the medicines that they need.” Patients were left “frustrated and inconvenienced” by drug shortages, she added. Read full story Source: The Guardian, 25 April 2022 -
Content ArticleThis case report in the journal Cureus examines the use of dalfampridine, a drug used to improve walking in multiple sclerosis (MS) patients. Dalfampridine can have serious side effects including inducing seizures. Although the US Food and Drug Administration (FDA) recommends stopping the medication permanently after a single seizure episode, this recommendation is not widely known by health care professionals. The authors argue that there is a need to raise awareness of the FDA recommendation and the potential for dalfampridine to cause seizures amongst primary and secondary care doctors and patients.
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Content ArticleChildren born to women who take valproate during pregnancy are at significant risk of birth defects and persistent developmental disorders. As such, it is vital that women and girls are dispensed valproate safely. The General Pharmaceutical Council is reminding all pharmacy professionals of what they must do to ensure women and girls receive the right information about valproate and the risk of birth defects. The update includes
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Content ArticleMedication safety events with the potential for patient harm do occur in healthcare settings. Pharmacists are regularly tasked with utilizing their medication knowledge to optimize the medication-use process and reduce the likelihood of error. To prepare for these responsibilities in professional practice, it is important to introduce patient safety principles during educational experiences. The Accreditation Council for Pharmacy Education (ACPE) and the American Society of Health-System Pharmacists (ASHP) have set forth accreditation standards focused on the management of medication-use processes to ensure these competencies during pharmacy didactic learning and postgraduate training. The experience described here provides perspective on educational and experiential opportunities across the continuum of pharmacy education, with a focus on a relationship between a college of pharmacy and healthcare system. Various activities, including discussions, medication event reviews, audits, and continuous quality improvement efforts, have provided the experiences to achieve standards for these pharmacy learners. These activities support a culture of safety from early training.
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Content Article
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 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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Content ArticleUnsafe medication practices and medication errors are a leading cause of injury and avoidable harm in health care systems across the world. The World Health Organization (WHO) has launched the Third WHO Global Patient Safety Challenge: Medication Without Harm to improve medication safety. Considering the huge burden of medication-related harm, Medication Safety has also been selected as theme for World Patient Safety Day 2022. WHO has launched a series of webinars to introduce the strategic framework for implementation of the Challenge, technical strategies, tools and provide technical support to countries for reducing medication-related harm. The webinars share country and patient experiences in implementing the Challenge. This webinar focuses on the role of patients and their families in improving medication safety, recognising that they are the only constants in increasingly complex healthcare systems, and that they can provide essential information and feedback.
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Content ArticleThe Additional Roles Reimbursement Scheme (ARRS) was introduced in England in 2019 as a key part of the government’s manifesto commitment to improve access to general practice. The aim of the scheme is to support the recruitment of 26,000 additional staff into general practice. This is a huge ambition and requires significant and complex change across general practice. While primary care networks (PCNs) have swiftly recruited to these roles, they are not being implemented and integrated into primary care teams in an effective way. This research by The King's Fund focused on four roles to examine the issues related to their implementation: social prescribing link workers first contact physiotherapists paramedics pharmacists. The research examined the experiences of people working in these roles, and of the people managing them. It found a lack of shared understanding about the purpose or potential contribution of the roles, combined with ambiguity about what multidisciplinary working would mean for GPs. If the scheme is to be successfully implemented, it will require extensive cultural, organisational and leadership development skills that are not easily accessible to PCNs.
