Patient safety is being put at risk in emergency departments because of missed doses of prescription medicines.
Research, as part of the Royal College of Emergency Medicine’s (RCEM) clinical Quality Improvement Programme (QIP) which aims to improve the care of patients in emergency departments, has found that many patients who rely on prescription medication to manage chronic conditions such as diabetes and Parkinson’s aren’t always getting these drugs when in A&E.
If a dose is delayed or missed, it can cause a person’s health to worsen. And if this delay is prolonged, the consequences can be severe.
The three-year QIP examines how time-critical medications are dealt with in practice when patients come to the emergency department and how clinical methods and patient safety can be improved.
“Everyone has a role to play – paramedics and EM staff need to ask patients what medications they take, and likewise, people with Parkinson’s and insulin-treated diabetes need to tell staff they take a time critical medication and take their meds with them if they have to visit an A&E,” said Jonny Acheson, an EM consultant in Leicester and director of engagement at the Parkinson’s UK Excellence Network. He has also been living with Parkinson’s himself since being diagnosed in 2016.
An excellent initiative
Across the UK, 136 Emergency Departments collated and analysed data for people living with diabetes and Parkinson’s. The QIP found more than half of eligible patients (53.4%) taking time-critical medication were not identified within 30 minutes of their arrival in ED. At the same time, around 68% of eligible patients’ doses weren’t administered within 30 minutes of the expected time.
In response to the findings, the QIP team has made three recommendations.
First, patients on time critical medication need to be identified early to start the process of getting all doses while in the ED. Second, systems need to be in place that will facilitate the timely administration of time-critical medication, including self-administration. And third, local EDs must have a clear governance structure in place to determine who is responsible for the prescribing and administering of time-critical medication in the ED from when the patient arrives, to when they are admitted to the ward or discharged.
The recommendations were welcomed by the Association of Ambulance Chief Executives (AACE).
“This excellent initiative should help raise the profile of this key issue and ensure more patients get their medicines on time,” said the organisation’s managing director Anna Parry.
“This is good news for patients, positive for ambulance people who can support patients getting their medications on time and will help ease pressure in emergency departments,” she added.
