Dimension: Medication Management

Rationale for measurement

Medicines are the most common treatment used in health care and contribute to significant improvement in health when used appropriately. However, medicines can also be associated with harm and the common use of medicine means they are associated with more errors and adverse events than any other aspect of health care. While rates of serious harm are low, errors can affect health outcome. The prevalence of medication errors is of particular concern because the majority of these errors are generally preventable.

Measurement methodology

In the absence of an internationally accepted robust method for measuring medication incidents, incidents are calculated per 100 Bed Days Used (BDU).

Target

  • there is no internationally accepted methodology for measuring medication errors or performance target and the RCSI HG does not have access to national performance data. However, internationally, incidents are estimated to occur at a rate of 1 error per hospitalised patient per day in the USA (Institute of Medicine USA Prevention of Medication Errors – 2006).

Performance

RCSI Hospital Group

  • whilst values demonstrated are significantly lower than US study, there is evidence that current reporting control constructs are less than optimal with resultant under-reporting at this time

Rationale for measurement

The use of medication remains the most common intervention in health care. The complexity of both medication use and the medication management process, especially in the in-patient setting, create a significant risk for hospitalized patients.

The indicators below are checking that all prescribed medication is administered in accordance with local and national policies, procedures, protocols and guidelines (PPPGs) and as documented in the Guidance for Nurses and Midwifery on medication management (NMBI 2020).

  • Patient’s weight and date of weight are recorded on the front page of the medication record
  • The patient’s identification wristband is on the patient and details are legible and correct
  • There are at least two identifiers, name and Date of Birth (DOB) (if Healthcare Record Number is not in use)
  • The allergy status is clearly identifiable on the front page of the medication record
  • The prescription is legible with correct use of abbreviations
  • All medicines were administered at the prescribed frequency

Measurement methodology and data sources

Based on total bed capacity, samples of 25% of patient records are randomly selected per month from each ward/unit with a minimum of 5 data collections per month for each ward/unit.

Target

100% compliance of the key indicators identified

Performance – February 2021