Two inspection reports on medication safety in public acute hospitals have been published today by the Health Information and Quality Authority (HIQA). HIQA monitors medication safety in hospitals against the National Standards for Safer Better Healthcare. Inspections were carried out in August 2017 at Letterkenny University Hospital and South Infirmary-Victoria University Hospital.

Letterkenny University Hospital

During an announced inspection in Letterkenny University Hospital on 3 August 2017, HIQA identified an immediate high risk relating to a relative lack of leadership, governance and management of medication safety related risks as a result of the suspension of the Drugs and Therapeutics Committee over a sustained period of time.

Inspectors found that in the absence of the committee, the hospital had no formulary; no strategic medication safety plan; no clinical pharmacist assigned to the paediatric and midwifery services; lack of an up-to-date, locally approved intravenous monographs at the point of care on both the paediatric and adult wards visited; and a lack of governance with regard to medicines information resources at point of care. The hospital also acknowledged that medication-related incidents were likely to be significantly under reported at the hospital. Notwithstanding these findings, clinical audit at the Letterkenny University Hospital was centrally coordinated and medication safety audit results were used as the basis for decision-making to support quality improvement medication initiatives which the hospital had implemented.

Due to the risks identified, HIQA wrote to the hospital to raise concerns over medication safety not being sufficiently supported by senior management and clinicians. Subsequently, Letterkenny University Hospital management team reported to HIQA that a number of measures had been taken to mitigate the risks identified during this inspection. The hospital must focus its efforts on addressing the risks and findings identified in this report, and work to ensure that the necessary arrangements are in place to protect patients from the risk of medication-related harm.

South Infirmary-Victoria University Hospital

An inspection in South Infirmary-Victoria University Hospital on 10 August 2017 found that the hospital had formalised governance arrangements and organisational structures in place to support the safe use of medicines. Medication safety was a standing item on the Drugs and Therapeutics Committee agenda. Hospital management had endeavoured to support and progress a medication safety agenda at the hospital through the formation of a Medication Safety Committee in June 2016. Notwithstanding this, inspectors determined that there was significant scope for improvement to further develop and promote a more effective culture of medication incident and near miss reporting. The hospital should endeavour to track and trend medication incidents reported to ensure that lessons are learned and staff can see what actions have been taken.

Overall, inspectors concluded that the hospital had conducted a number of audits relating to medication management. In order to enhance the current approach, the hospital would benefit from taking a more structured approach to the planning of audit in the area of medication safety aligned to a formal medication safety strategy.

HIQA concluded that the South Infirmary-Victoria University Hospital should build on their work to date to develop and implement a medication safety strategy and operational plan that sets out a clear vision for medication safety across the organisation.