MEDICATION SAFETY MONITORING
As modern medicine continues to advance, increasing medication treatment options are available for patients with proven benefit for treating illness and preventing disease. This advancement has brought with it an increase in the risks, errors and adverse events associated with medication use. While most medication errors do not result in patient harm, medication errors have the potential to result in catastrophic harm or death to patients in some instances.
As modern medicine continues to advance, increasing medication treatment options are available for patients with proven benefit for treating illness and preventing disease. This advancement has brought with it an increase in the risks, errors and adverse events associated with medication use. While most medication errors do not result in patient harm, medication errors have the potential to result in catastrophic harm or death to patients in some instances.
Medication safety has been identified internationally as a key area for improvement in all healthcare settings. 2 In March 2017 the World Health Organization (WHO) identified Medication Safety as the theme of the third Global Patient Safety Challenge. This global safety initiative aims to address the weaknesses in health systems that lead to medication errors and the severe harm that may result. The WHO sets out its specific aim to ‘reduce the level of severe avoidable harm related to medications by 50% over 5 years globally’. This global safety initiative is also a key area for improvement in an Irish context.
It is known, that the medicines developed for treatment of diseases, have also side effects, sometimes dangerous for life. There are no absolutely safe medicines! Moreover, the use of medicines in a wide exposition may cause various adverse reactions of drugs (ADR) which were not registered during clinical trials because of the limited quota of the patients. Revealing, registration and analysis of the ADR (Pharmacovigilance) are necessary for the subsequent specification of the drugs' indications, contra-indications, side effects, dosages, etc.
What are the stages of Monitoring Medication Safety?
STAGE
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INDICATOR
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Acquisition
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Formulary control
Stock level control
Stock out Prevention
Local purchases
Emergency drug availability
Minimum Order levels
Use Of ABC or VED Process
Deviation from documented purchase process
Goods rejection rate
Vendor monitoring
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Storage
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First in first out
First expiry, First out
Near expiry drug control
Temperature, humidity control
Storage of
Emergency drugs
Crash Cart drugs
Ambulance drug kit
Refrigerated Storage
LASA
HRM
Chemotherapy drugs
Narcotic and psychotropic drugs
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Prescription
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Monitoring of
Outpatient prescription
Inpatient prescription
Patient education
Rationality of prescription
Prophylactic antibiotic usage
Use of high end antibiotics
Use of narcotics
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Dispensing
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Monitoring of
HRM reaffirmation
Labelling of the drug package
Expiry date monitoring
Cut strip dispensing and storage
Patient education
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Administration
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Correct drug preparation
Syringe labelling
Correct use of multi dose vials
Rights of administration
Patient
Drug
Dose
Route
Time
Documentation
HRM administration
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Monitoring
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Medication errors
Adverse events
Adverse drug events
Adverse drug reactions
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ADR
Adverse Drug Reactions (ADRs) are among the top ten leading causes of death in most of the countries. An adverse drug reaction could be any unintended reaction in patients body which occurs as a result of administration of drug. Drug safety monitoring is a risk mitigation exercise in which the ADRs caused by therapeutic drugs, biologicals or devices can explored, prevented or minimized.
It is the process of identifying expected and unexpected adverse reactions resulting from the use of medicines in the post-marketing phase. Pharmacovigilance is an umbrella term used to describe the process of drug safety monitoring and can be defined as the branch of science that carries out activities related to detection, assessment, understanding and prevention of adverse drug reactions. It primarily aims at rational use of medicines to assure safety of patients. Thus pharmacovigilance has become a key aspect of effective clinical practice in many countries.
According to the order of the Ministry of Health, which is an authorized governmental body, ADR monitoring in RA is carried out by the Scientific Centre of Drug and Medical Technologies Expertise, which has been a member of the WHO International Program of the ADR Monitoring (Uppsala, Sweden) since 1997.
For the purpose of ADR monitoring and according to the international recommendations, the Report Form for ADR registration has been developed at the centre, and it is being actively spread among the workers of public health services.
Credit:Sivakumar Murugesan,Quality Accreditation Consultant,Medpoint Healthcare
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