Three 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 and September 2017 at Mayo University Hospital, Our Lady of Lourdes Hospital, Drogheda and Mercy University Hospital Cork.

Our Lady of Lourdes Hospital, Drogheda

An announced inspection of Our Lady of Lourdes Hospital Drogheda was carried out on 31 August 2017. HIQA found that the medication safety agenda was being actively progressed at Our Lady of Lourdes Hospital through the work of the Drugs and Therapeutics Committee supported by the Medication Management Subgroup.

There was multidisciplinary involvement with engagement and support from senior hospital managers and clinicians working to provide medication safety across the hospital. Hospital staff carried out audits which supported medication safety.

The hospital did not have a medication formulary, locally adapted intravenous monographs or clinical pharmacists in specialist clinical areas and the hospital should look to address these deficits in a sustainable way following this inspection.

The hospital had identified low medication incident reporting rates and had taken steps to address this following the introduction of the National Incident Management System by way of staff education sessions.

Mayo University Hospital

During the announced inspection at Mayo University Hospital on 24 August 2017, HIQA found that the hospital had an established Drugs and Therapeutics Committee that provided governance and oversight of the medication management safety systems within the hospital. The hospital had a medication safety strategy in place which was being actively progressed. A number of priority medication safety quality improvements had been implemented which were supported by policies.

However on the day of inspection, inspectors found that the hospital did not have a hospital wide drug formulary in place and there were limited clinical pharmacy services available in the hospital, including the paediatric and maternity wards. Despite having a system for reporting medication incidents and near misses, reporting was low.

Current medication safety auditing arrangements should be strengthened and formalised with an audit plan to regularly provide assurance to the Mayo University Hospital Management Team about medication safety at the hospital.

Mercy University Hospital Cork

An announced inspection in the Mercy University Hospital on 5 September 2017 found that although the hospital had an established Drugs and Therapeutics Committee in place, some of the systems, processes and practices to support medication safety were still under development. HIQA found that the hospital did not have a formal medication safety programme in place, underpinned by an overarching medication safety strategy or prioritised on the basis of identified risk.

Reported medication incidents and near misses were tracked and trended to assess progress and to identify emergent medication safety concerns. Medication-related incidents and near misses were analysed and actions were taken to address them to prevent reoccurrence. However, there was an opportunity to improve rates of medication related incident and near miss reporting by all clinical staff.

The inspection team was provided with examples of hospital-specific medication safety audit activity. These auditing arrangements should be strengthened and formalised to regularly provide assurance to the hospital corporate management team about medication safety at the hospital.

Hospital management and staff need to build on their work to date to develop a medicines safety strategy that sets out a clear vision for medication safety across the organisation.