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Patient safety: an unobtainable goal?


Chris Cairns,
Consultant Editor

One of the major themes at the recent European Association of Hospital Pharmacists conference was patient safety. As hospital pharmacists, we are all aware of the potential dangers of drug therapy. In addition to adverse drug reactions (ADRs), patients can suffer from misadventures due to prescribing, administration and/or dispensing errors. Optimising patient safety is therefore about minimising errors, preventing avoidable ADRs and promptly managing ADRs when they do occur.

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So how do we achieve these goals? There are two basic components. The first is ensuring that our systems for dealing with medicines are robust and safe. Many errors are due to failures in the system rather than negligence or lack of knowledge. There is much we can learn from the airline industry, which for many years has applied a whole systems approach to dealing with adverse incidents. We also have to recognise that there may be more than one solution. The 1960s was the first time that medication administration errors (MAEs) were identified as a major problem. Different solutions were used in different countries, but two main strands emerged: unit-dose systems and robust documentation, both backed by the development of clinical pharmacy services. Recent research has shown that both these systems have their limitations, which differ, as well as their strengths as safety processes. Much of the research has also shown that there is scope for improvement.

The second component is having a knowledgeable and competent workforce. Knowledge is continually being updated and evidence produced. This means that to remain competent health professionals have to continually update themselves. A few years ago, it was reckoned that to keep up to date in their own specialty, a health professional would have to read about 60 journal articles each day. We pharmacists often have to keep up to date with other specialties and healthcare developments generally. I also think that the amount of information and evidence available is mushrooming, so the number of articles we need to read is anyone’s guess. Unfortunately there is not enough time for one to do all this reading, so we need to be selective. Alternatively, it is helpful if someone else goes through the literature and screens out the important information for us. Hence the value of abstracting services and review journals. Review articles make up much of our material in HPE. To assure quality, we use a large number of respected health professionals across Europe and beyond to write our articles. I hope you, the reader, find their hard work useful to you in your work, if only to prevent you and your staff spending all day reading the 60 or so articles to keep yourself up to date. To continue to receive your complimentary copy of HPE, you an now register online at, or complete and return the reader reply card included with this issue.

Chris Cairns, Consultant Editor

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