A New Medication Culture to Reduce Medication Errors. A pharmacist’s view

With researchers from the Universities of York, Manchester and Sheffield recently publishing a report which reveals a strikingly high incidence of medication errors in the NHS, leading commentators and the government have focused their attention on the issue. Although technology is a key factor in helping reduce the incidence of this type of error, Health and Social Care Secretary Jeremy Hunt has called-out the need for ‘teamwork and communication’, a combination that we at BD would argue is critical to ensuring patient safety.  

At BD we’ve been campaigning to bring the right level of attention to patient safety across a variety of adverse events including medication errors. In fact, studies show that 18.7% – 56% of all adverse events among hospitalized patients result from preventable medication errors. Typically medication errors take place at the prescription, dispensing and administration stages.

A number of studies show that IV administration is a frequent contributor to medication errors and injuries that result from them, making this a key process to focus on for improvement. Increased automation of processes at the administration stage can also play a critical role helping reduce dose error reduction via closed-loop solutions combining an updated and extensive drug library, infusion analytics, enterprise management software and patient-centred clinical services. At the preparation phase, standardising workflow through an integrated, fully traceable gravimetric solution helps not only avoid error, but perform more accurate audits.

Dispensing stage errors are also frequent and under-reported, meaning their incidence could indeed be much higher than we think. Typically these errors are due to human error such as confusing look-alike packaging or sound-alikes, high pharmacy workloads, low staff numbers, staff inexperience, and rushing to complete tasks. Automation in the pharmacy and the ward can also prove instrumental at the dispensing stage, helping staff locate the right drug, in the right dosage at the right time, promoting greater safety, but also general efficiency.

Finally, although prescription errors are less frequent they are also under increased scrutiny with e-prescribing solutions providing a helpful tool. Automated and standardised physician planning solutions – such as e-prescription systems – can be applied to help reduce prescription errors especially when these caused by inaccuracies resulting from staff shortages and lack of time.

While specific processes require particular attention the over-arching requirement is that of establishing a culture of patient safety: the entire medication management process needs to be optimised and while technology will play a critical role, the human element is critical to its success. Training, but also informal activities such as ward-walks and interviews with nursing and pharmacy staff, play a critical role in supporting hospitals to manage risk alongside the implementation of automation and technology.

The implementation of a holistic patient safety culture and automation also critically enables the achievement of ‘The Five Rights of Medication Administration’ as set out by the Institute of Healthcare Improvement, which recommends that to reduce medication error and harm it is necessary to keep in mind the following: the right drug administered to the right patient, at the right dose, via the right route and at the right time.

It’s therefore clear that engaging in innovation isn’t just about purchasing new technology, but also means understanding the potential benefits it can bring when combined with training and engaging staff so they are enabled to ensure that patient safety is promoted across the board.

Dipak Duggal, MRPharms, MBA, Director Global Solutions & Marketing at BD (Becton, Dickinson and Company) Dispensing Hospital International


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