The design, implementation, and evaluation of a medication safety programme in an acute Irish teaching hospital

THESIS 8967The research undertaken for this thesis aimed to address the current deficit which exists in relation to the status of medication safety in Irish hospitals and add to the limited body of published data available from any jurisdiction in relation to the operation of hospital medication safety programmes. This thesis commences with a description of a template for the design and implementation of the ideal medication safety programme, based on a synthesis of the 6 years experience of the author as a medication safety officer and on review of the literature. The medication safety programme designed for an acute teaching hospital in Ireland (Hospital X) was then compared to this template in order to profile the progress made by the hospital to date and highlight future areas for development. An analysis of the medication safety errors submitted to a voluntary reporting system in Hospital X over a period of 5 years was then undertaken. An epidemiological approach was adopted in relation to the data analysis which involved first investigating the complete dataset and then focusing on the subset of errors which had caused harm to patients. The trends regarding reported errors in Hospital X were found to be broadly in line with those established in relation to large-scale national reporting systems: a minority of errors resulted in patient harm (6.2%); the most frequently reported error types were ?missed dose? and ?incorrect dose? (19.7% and 16.5% of the total, respectively); a small number of event types (10) accounted a majority (70%) of patient harm; and the medications most frequently associated with patient harm were opiates, cardiovascular agents, and insulin (which accounted for 49% of all harmful events)