Medicines Safety Laura Graham Clinical Pharmacist April 2019 - PowerPoint PPT Presentation

Medicines Safety Laura Graham Clinical Pharmacist April 2019

Medicines Safety  Clinical Pharmacy Service  Medicines Reconciliation  “Alarm bell” Medications

Clinical Pharmacy Service  Opening hours & on-call  Cover assessment / critical care / surgical / medical / aseptic / psychiatry  Medication review and patient triage  Prescribing advice  Discharge prescriptions WE DO NOT DO MED REC

Medication review and triage  Aim to review and triage patients as soon as possible after admission  Patients on high risk medications – we aim to review daily  Expect us to seek you out to discuss treatment choices  Look out for pharmacist/technician comments in notes – often in green pen!

Pharmacy’s role in discharge prescriptions - Clinical first stage – ward level M-F IDL screen / notes / medicine chart / PODs / patient - - Dispensing – pharmacy / ward / ward staff medicines gathered & labels on boxes - - Final accuracy check emailed to GP / community pharmacy and patient / - secretary copy printed

Electronic IDL & progress tracker

Med Rec - National targets  SPSP target that within 24 hours of admission ≥ 95% of cases have:  Demographics recorded  Allergy status recorded  2 sources (one the patient/carer if possible)  Plan (Continue / Withhold / Stop) for each medicine documented (requires clinician input)

Med Rec Process  Collect – use the most appropriate sources given the patients circumstances eg. Print med rec report from ECS on clinical portal  Confirm – using patient/carer  Communicate – document plan on med rec proforma. If any issues document follow up in management plan

Printing the ECS is NOT medicine reconciliation!!

Med Rec sheet in admission docs Copying a list of medicines onto this form introduces errors! Use med rec report print out from clinical portal

Printing med rec report from Portal

Med Rec report from Portal

Our current performance 2019 - Med rec sheet used? 2019 - Second source 11% 22% 6% Yes - patient/carer Yes - other No 78% 83% 2019 - Continue/ withhold/ disc 2019 - Was the med rec accurate? 37% 46% 54% 63%

“Alarm Bell” Medications  Warfarin  DOACs  Insulins  Methotrexate  Colchicine  Gentamicin / Vancomycin  Clozapine  Parkinson’s Disease meds  Anti-epileptics

And finally...  Pharmacy are here to help!