On the previous inspection, Midland Regional Hospital Tullamore had the required governance structures and arrangements in place for oversight of medication safety. However, during this inspection HIQA found governance and oversight of medication safety were impacted by unplanned reductions in pharmacy resources. As a result, the Pharmacy and Therapeutics Committee was not functioning in line with its terms of reference, which had a direct impact on the provision of clinical pharmacy services and medication reconciliation. Medication incident reporting had significantly decreased since the last inspection and there was a lack of analysis, trending and tracking of medication safety incidents in the previous year.
Despite these challenges, the hospital’s pharmacy department continued to provide a responsive service for staff and patient review within its limited resources. The hospital had identified high-risk medications in use and had implemented a combination of risk reduction strategies to mitigate risk associated with these medications. Inspectors found staff had a good awareness of these in clinical areas visited.
There was a system in place for the approval of new medicines, an approved list of medications (formulary) and inspectors saw easily accessible evidence-based medication information sources in clinical areas.
Hospital management must, as a priority, work towards re-establishing the services required for medication safety and put in place contingency arrangements, where required. The medication safety programme should be restored, directed by a medication safety strategy, to ensure that the considerable efforts taken towards improving medication safety over a number of years are not lost due to current challenges.