HIQA: Temple St Children's Hospital should have clinical pharmacy service

Health watchdog HIQA has said Temple St Children's Hospital should have a clinical pharmacy service for all patients and also said the "over-reliance on nursing staff to report medication incidents needs to be addressed".

The findings are in an inspection report into medication safety at Children’s Health Ireland at Temple Street, following checks conducted last November.

The Health Information and Quality Authority found the facility overall "had some essential elements in place to support effective oversight and governance, however further work was required to comprehensively support medication safety at the hospital".

In many areas it was in full compliance with expected standards but according to the report: "The ongoing lack of a comprehensive clinical pharmacy service for all patients at the hospital remained a concern to HIQA given the size, speciality and complexity of services provided by the hospital."

It said a total of 373 medication incidents were reported up to November 2019, compared with 587 incidents reported in 2018 and 800 medication incidents reported in 2017.

HIQA said increased reporting was encouraged through a ‘good catch system’ where staff were encouraged and supported to report near-miss incidents, adding: "the hospital should look to undertake a review of the recent decline in medication safety incident reporting rates and implement the necessary measures to ensure that medication safety surveillance is improved, learning is shared and a safety culture is promoted and enhanced across the organisation".

The majority of medication incidents were reported by nurses, with some reported by clinical pharmacists and low reporting rates by doctors. HIQA said: "The over-reliance on nursing staff to report medication incidents needs to be addressed."

Children’s Health Ireland at Temple Street did not have a high-risk medications list in place at the time of inspection and the pharmacy department reviewed 24 medication administration charts and 88% of those charts contained at least one error.

"HIQA acknowledges actions taken by hospital management to increase pharmacy resources and recognises that the hospital must now be supported by the hospital group to ensure pharmacy staffing levels reflect the size and complexities of the services provided in line with other tertiary referral paediatric hospitals and theNational Model of Care for Paediatric Healthcare Services in Ireland," it said.