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Risk assessment of parenteral product preparation across secondary care acute trusts in the north of England

By Linda Hardy, BSc, MRPharmS, and Liz Mellor, MPharm, MRPharmS

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Linda Hardy is project manager for reducing risk with parenteral therapies and Liz Mellor is clinical governance lead pharmacist, both at Leeds Teaching Hospitals NHS Trust.

Correspondence to
Linda Hardy at linda.hardy@leedsth.nhs.uk

ABSTRACT

OBJECTIVE — To assess the extent of, and the risks posed by, the preparation of parenteral products in secondary care acute trusts in the north of England.

METHODS — The frequency of preparation in near-patient clinical areas of a range of high risk parenteral products was assessed by ward-based pharmacy staff, using standard data collection forms. The total number of doses of parenteral products of all risk ratings prepared within all NHS pharmacy parenteral preparation units in the north of England was reviewed.

SUBJECTS AND SETTING — Secondary care acute trusts covered by the Local Review Group (North). All near-patient clinical areas where parenteral products are prepared. All NHS pharmacy parenteral preparation units.

OUTCOME MEASURES — Measurement of the extent of high risk parenteral product preparation being undertaken in near-patient clinical areas. Comparison with the total output of services provided by the pharmacy parenteral preparation units.

RESULTS — A total of 1.2 million doses of high risk preparations were prepared in near-patient clinical areas per annum. The total number of products in all risk categories prepared in pharmacy parenteral preparation units was
2.3 million doses per annum.

CONCLUSIONS: Improvements in patient safety may be gained by the optimisation of pharmacy manufacturing and preparation services. Optimising such services will need to be an ongoing, collaborative and multidisciplinary process.