Hiqa criticises hospital over medication safety

University Hospital Limerick has been criticised over medication safety, with inspectors claiming that “the collective nature of the risks identified presented potential risks to patients”.

The inspection was conducted by the Health Information and Quality Authority (Hiqa) and found “inherent weaknesses in the existing medication safety systems and processes at the hospital”.

They included inadequate arrangements in place to identify, report, and manage risks associated with medication use, resulting in poor awareness and underreporting of medication errors and near misses.

Among other issues, inspectors noted a lack of a cohesive approach to governance and oversight of the provision of pharmacy services to five sites within the group and poor compliance by the hospital drugs and therapeutic committee with its own terms of reference.

The inspection was conducted on May 18 and involved several interviews with senior hospital personnel, visits to the Rainbow Ward and the 3B ward, discussions with staff, a review of documentation, and a survey of outpatients in the outpatient department.

According to the Hiqa report: “Details of these risks were communicated to hospital management at the time of this inspection, and in writing following this inspection.

“It was of concern that a tertiary hospital providing complex clinical care did not have a sufficiently defined medication safety programme in place.

“Moreover, it was not apparent that medication safety was adequately supported at executive management level at the hospital.”

Hiqa also said that the hospital reported 138 medication-related incidents and near misses during 2016.

“Hiqa noted the low numbers of medication- related incidents reported throughout 2016, relative to other hospitals inspected so far through this monitoring programme,” it reported.

“Near misses in relation to medication-related issues were not being reported. As a result, key medication- related risks could not be understood, recorded, escalated, or mitigated effectively by the organisation.”

The report acknowledges that the hospital has been working on addressing the shortcomings and hospital management provided Hiqa with a quality improvement plan.

“However, it is of note that there are no timelines associated with the completion of this quality-improvement plan,” it said.

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