Policy responses and statements

Name of organisation:

National Patient Safety Agency

Name of policy document:

Safer Use of Injectable Medicines in Near-Patient Areas

Deadline for response:

31 March 2006

Background: The National Patient Safety Agency is undertaking a wide stakeholder consultation on recommendations intended to improve the safe use of injectable medicines in near-patient areas.

Risks associated with the use of injectable medicines in near-patient areas have been recognised for some time. The objective of this patient safety alert is to introduce a co-ordinated approach to ensure that injectable medicines are used safely in healthcare organisations. This will be achieved by raising awareness of the risks of using injectable medicines, providing a quick and easy to use risk assessment tool and aid organisations to prioritise actions that can help minimise latent system risks.

The NPSA intends to issue final recommendations to improve the safer use of injectable medicines in the NHS in England and Wales later in 2006.

COMMENTS ON
NATIONAL PATIENT SAFETY AGENCY
SAFER USE OF INJECTABLE MEDICINES IN NEAR-PATIENT AREAS

The Royal College of Physicians of Edinburgh welcomes the National Patient Safety Agency’s document which addresses an important area, the safer use of injectable medicines in near-patient areas. The College’s comments are as follows:

• Given the scale of injectable medicine use in modern healthcare, the potential for patient harm is high.

• The document seeks to provide a quick and easy assessment tool for injectable medicines.

• The risk assessment sheet appears to be easy to understand and relatively simple to complete.

• The report also recommends written protocols for all near-patient injectable preparations (prescription, preparation, and administration).

• Staff prescribing, preparing and administering injectable medicines should have acquired the necessary work competences for the task.

• There should be an emphasis on extra training required in particular situations known to be of high risk from previous reports eg inappropriate intrathecal injection of vinca alkaloids.

• It is somewhat difficult to imagine a written protocol for every occasion, but this should be possible for listed high risk products where a risk assessment has already been conducted. Any protocols so produced should be brief, lucid and useful rather than over- long and unreadable.

• The use of licensed ready-to-administer/ready-to-use products would clearly create less risk, but one would want to know if there is likely to be a detailed economic evaluation of these products to answer the cost-effectiveness question.

• The recommendation that incidents with injectable medicines should be reported in a standardised format to facilitate retrieval locally and nationally is a laudable aim. This would guide further risk assessments and safety improvements.

• It is noted that organisations should produce an injectable medicines report annually, summarising risk assessment results, incident reports and compliance with NPSA recommendations. Their report would go to the Clinical Governance and Drugs and Therapeutics Committee of each organisation annually. It would be used as part of the performance management process by any external agency. One does wonder how manageable the consequent form filling, collation, risk assessment, and report production would be, given the volume of bureaucracy and paper work this exercise would generate.

Copies of this response are available from:

Lesley Lockhart,
Royal College of Physicians of Edinburgh,
9 Queen Street,
Edinburgh,
EH2 1JQ.

Tel: 0131 225 7324    ext 608
Fax: 0131 220 3939

[28 March 2006]