Wide range of medication risks found at Limerick hospital

Health watchdog finds failures to meet even minimum standards for management

A recent inspection at University Hospital Limerick has revealed a "wide range of risks" related to the hospital's medication safety practices.

A report released by the Health and Information Quality Authority (Hiqa) today following the inspection on May 18th found the hospital had failed to meet even minimum standards in the area of medication management.

Medication errors and near-misses were underreported at the 560-bed facility, and governance arrangements relating to medication safety were described as “fragmented” and “underdeveloped”.

Lessons learned from these errors and near-misses were not used to inform an improved future approach, and it was noted that many of the elements required to improve the safety and quality of medicines were not in place.

Inspectors remarked that there were inherent weaknesses in the hospital’s medication systems, processes and level of resourcing, and that it was “not apparent that medication safety was adequately supported at executive management level”.

The Hiqa report also said “it was of concern that a tertiary hospital providing complex clinical care did not have a sufficiently defined medication safety programme in place.”

A poor level of compliance by the hospital’s drugs and therapeutic committee with its own terms of reference was evident, according to the report, which further found that there was an absence of strategic planning relating to medication safety systems.

Hiqa wrote to University Hospital Limerick on May 23rd in light of the adverse findings to seek assurances that the issues identified would be adequately addressed.

The hospital responded with a quality improvement plan on June 6th, however there were no timelines associated with this plan and so Hiqa has ordered that a follow-up inspection take place within six months to monitor progress in the area.

“University Hospital Limerick needs to assure itself that defined and appropriate timelines are in place to address the risks identified by Hiqa as a matter of priority,” read a passage of the report.

Inspectors noted that hospital management were aware of some of the deficiencies in practice at the time of the visit, and had already acted to address a number of shortcomings.

It was also commended for its implementation of safety alerts in relation to some medications including insulin and paracetamol, as well as its introduction of a new drug kardex.

Elsewhere, an inspection of Tallaght Hospital carried out by Hiqa on May 10th recorded effective governance and oversight of medication safety in all adult services.

Hiqa officials observed that other hospitals would benefit from studying the safety measures and innovative practice evident at Tallaght Hospital.