Medication Safety Thermometer Event Thursday 23rd January 2014 Quiz About Medication Errors 1. In their fourth report, how much did the NPSA estimate is spent on medication errors in the NHS yearly? A) £75 million B) £750 million C) £1.2 billion D) £80 million 2. Which four High Risk drug groups does the Medication Safety Thermometer monitor? A) Injectable sedatives, Insulin, Opiates, Hypotensives B) Injectable sedatives, Insulin, Opiates, Anticoagulants C) Respiratory, Insulin, NSAIDs, Hypotensives D) Diuretics, Insulin, Anaesthetics, Anticoagulants 3. What may a medication error lead to… A) An Adverse Drug Event B) Increased monitoring of a patient C) Extended length of hospitalisation D) All of the above 4. Name 4 stages in the medication use process where an error can occur.. E.g. Prescribing stage 1 point for each! 5. In the Pincer trial (2012)which of the following three options were the clinically important errors the research team sought to measure (Choose 3) A) NSAIDS (e.g. ibuprofen) prescribed without a PPI to patients with a history of peptic ulcers D) β blockers (e.g. bisoprolol) prescribed to those with a history of Respiratory Disease B) ACE inhibitors or loop diuretics given to 75+ patients without a U&E assessment in the preceding 15 months E) β blockers (e.g. bisoprolol) prescribed to those with a history of asthma C) ACE inhibitors or loop diuretics given to 70+ patients without a U&E assessment in the preceding 15months F) NSAIDS (e.g. ibuprofen) prescribed to those with a history of Asthma End of quiz Answers to follow Answers 1. 2. 3. 4. B B D Possible Answers: Prescribing, Transcribing, Dispensing, Administration, Monitoring or Checking 5. A,B,E References Question… 1-National_Patient_Safety_Agency (2007). THE FOURTH REPORT FROM THE PATIENT SAFETY OBSERVATORY, Safety in doses: medication Safety incidents in the NHS. London, The National Patient Safety Agency 2 &3 -Cousins, D. W., Steve; Jani, Yogini; Power, Maxine; Warren, Abigail; Griffith; Michelle; Bramfitt, Kurt; Medications Safety Thermometer-A preliminary pilot guide. NHS. 4-Hughes RG, Blegen MA. Medication Administration Safety. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 37. Available from: http://www.ncbi.nlm.nih.gov/books/NBK2656/ 5-Avery, A. J., et al. (2012). "A pharmacist-led information technology intervention for medication errors (PINCER): a multicentre, cluster randomised, controlled trial and costeffectiveness analysis." The Lancet 379(9823): 1310-1319.