Health safety watchdog raises serious concerns over medication risks at hospital

Management at Letterkenny hospital takes measures to address risks highlighted during August inspection

A total of 276 medication incidents were reported at Letterkenny hospital between March 2016 and July 2017. Photograph: Trevor McBride

The health safety watchdog has raised serious concerns about medication safety risks at Letterkenny University Hospital.

The watchdog found “an immediate high risk relating to a relative lack of leadership, governance and management of medication safety”.

Inspectors from the Health Information and Quality Authority (Hiqa) carried out an announced inspection at the hospital on August 3rd last.

Their report said the risks were related to the suspension of the hospital’s drugs and therapeutics committee over a “sustained” period.


The inspectors found this meant, among other things, that the hospital had no strategic medication safety plan and no clinical pharmacist assigned to the paediatric and midwifery service. There was also “a lack of governance with regard to medicines information resources at point of care”.

The hospital acknowledged that medication-related incidents were likely to be “significantly under-reported”.

A total of 276 medication incidents were reported at the hospital between March 2016 and July 2017, which the hospital acknowledged was “low” relative to the numbers reported in other hospitals.

About 78 per cent of reports were submitted by clinical pharmacists, with limited evidence available to suggest that medical and nursing staff were reporting medication incidents, Hiqa said.

Due to the risks identified, the authority wrote to the hospital to raise concerns over medication safety not being sufficiently supported by senior management and clinicians.

The management team subsequently reported that a number of measures had been taken to mitigate the risks identified during the inspection. These included strengthening governance structures to sustain a re-formed drugs and therapeutics committee. The hospital also planned to establish a medication safety programme and to promote patient safety relating to medicine usage in the hospital.

“The hospital must focus its efforts on addressing the risks and findings identified in this report, and work to ensure that the necessary arrangements are in place to protect patients from the risk of medication-related harm,” Hiqa said.

A separate inspection by Hiqa of the South Infirmary-Victoria University Hospital in Cork on August 10th last found the hospital had formalised governance arrangements and organisational structures to support the safe use of medicines.

However, inspectors determined that there was “significant scope for improvement to further develop and promote a more effective culture of medication incident and near miss reporting”.

“The hospital should endeavour to track and trend medication incidents reported to ensure that lessons are learned and staff can see what actions have been taken.”

Hiqa said error associated with medication usage was one of the major causes of patient harm in hospitals.