Papers

Overcoming cost-related and other barriers to implementing risk-reduction strategies for injectable therapies

By Anne Black, MRPharmS, Catherine Tucker, MRPharmS, and Clare MacGregor, MRPharmS

This article as a PDF (50K)

Anne Black is quality assurance pharmacist

Catherine Tucker is critical care pharmacist

Clare MacGregor was a rotational pharmacist at the time of the study

all at Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust.

Correspondence to
Anne Black (Anne.Black@nuth.nhs.uk)

ABSTRACT

OBJECTIVE — To identify risk reduction measures in relation to injectable therapy, to propose and implement patient safety improvements and to estimate the costs associated with them. To identify barriers which might hinder the implementation of a “purchasing for safety” initiative.

SUBJECTS AND SETTINGS — Clinical areas at Freeman Hospital, Newcastle upon Tyne, including general intensive treatment unit (ITU), cardiology ITU and a surgical ward.

OUTCOME MEASURES — Identifying costs associated with injectable medicines prepared in clinical areas. A pathway to the development of a robust approval process for procurement of medicines with inherent safety features in preference to those without.

METHODS — Higher risk items made in clinical areas were identified. Risk reduction measures were implemented and evaluated.

RESULTS — A variety of risk reduction measures were implemented, including provision of ready–to–use and ready–to–administer products, dose calculating tools and protocols for complex methods remaining in clinical areas.

CONCLUSIONS — Risks can be reduced for injectable medicines prepared in clinical areas. Risk reduction measures have costs associated with them. Even though barriers to implementation of these measures are frequently raised, it is possible to make safety improvements in a budget conscious trust.