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Reporting, Review and Application of Near‐Miss Prescribing Medication Incident Data
Author(s) -
D'Souza Deirdre C,
Koller Lorraine J,
Ng Kingsley,
Thornton Penelope D
Publication year - 2004
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/jppr2004343190
Subject(s) - medicine , pharmacist , clinical pharmacy , quality management , chart , patient safety , medical emergency , pharmacy , family medicine , health care , management system , operations management , statistics , mathematics , economics , economic growth
Prospective drug chart review by pharmacists is an important risk minimisation strategy in the detection and prevention of prescribing medication incidents (PMis). Feedback reporting to the clinical team facilitates learning from and the identification and prevention of system‐based PMis. At Westmead Hospital, Sydney, the establishment of a relational database ofprevented‐PMis in November 2001 enabled such feedback reporting. Assessment of the reporting process after 12 months indicated review and application of the data within quality frameworks, value in improving prescribing practice and continued interest in receiving the reports. Implementation of feedback reporting has facilitated learning from PMis beyond the prescriber to the team and organisational levels. PMI data have been incorporated into ‘safe prescribing’ training programs for junior doctors. The proactive role of the clinical pharmacist in ensuring safe medication outcomes has been highlighted. Establishment of data management and reporting processes may assist future incorporation into wider incident‐monitoring systems.