Clinical Indemnity Scheme has issued new guidelines on dispensing medicine, writes CARL O'BRIEN
NEW FIGURES compiled by the Clinical Indemnity Scheme show that between 2004 and 2010 there were a total of 124 claims for compensation as a result of medication errors.
Of these, more than a quarter (33) involved the prescribing of a medicine that can cause a severe allergic reaction. This error led to fatalities in four patients, two of which were accounted for by administration of penicillin- containing products.
Other patients experienced serious ill-health leading to admission to intensive care units and increased length of stay in hospital.
The issue is not confined to Ireland, but is common across healthcare systems internationally. An analysis of the most severe forms of allergic reaction to medication – known as anaphylactic reactions – in the UK found there were some 88 deaths over a 10-year period.
Experts found that anaesthetics, principally muscle relaxants or “neuromuscular blockers”, were responsible for the largest number of deaths, followed by antibiotics and “contrast media” – substances used to enhance the contrast of fluids in medical imaging.
A breakdown of statistics released by the Clinical Indemnity Scheme in Ireland shows there were 35,510 “events” relating to medication safety, ranging from near-misses to more serious events between 2004 and 2010. Of these, 751 were linked to an adverse reaction to a known allergen. The prescribing of two drugs which contain penicillin – Augmentin and Tazocin – accounted for 149 of these events.
In response to the findings, the scheme has offered fresh guidance to health professionals involved in the administration of drugs. The guidelines include the following safety tips:
Ensure patients understand their allergies and are aware of medications to avoid.
Check the allergy status of drugs immediately before prescribing, dispensing or administering medication: the failure to consider allergies at this stage is a “crucial contributory factor”.
Check reliable references for cross- allergies, such as the Irish Medicines Board (imb.ie): lack of knowledge on which medications contain allergens is common among health professionals.
Document allergies to medication: lack of reliable information regarding a patient’s allergy history at the point of prescribing, dispensing or administering medication can result in errors.
Put computerised prescribing systems to good use: these can minimise the risk of errors if configured to take into account information on allergies.
Improve treatment of anaphylaxis: rapid, evidence-based treatment can minimise the impact on the patient. Without it, results can be fatal.
Officials have also issued a series of safety steps for health professionals who believe a patient has an allergy or intolerance, but the history is inconsistent with this.
These include amending all existing records, where appropriate, to minimise the chance of an error occurring in future.