WHO World Patient Safety Day 2022

The World Health Organization (WHO) World Patient Safety Day takes place on 17 September every year. The theme for 2022 is Medication Safety. The Commission continues to support WHO in their efforts to increase safe use of medicines.

Overview

Medications are the most widely used intervention in healthcare. Unsafe medication practices and medication errors are the leading cause of avoidable harm in Australia, and globally. This is seen as a result of a combination of factors including medication prescribing, dispensing, administering and monitoring processes.

This year's World Patient Safety Day theme of Medication without harm focuses attention to strengthen these processes and ensure safe and quality use of medicines. Healthcare providers and patients are encouraged to prioritise medication safety, and take action to reduce medication-related harm across three flagship areas:

  1. Monitoring polypharmacy and responding to inappropriate polypharmacy
  2. Reducing harm from high-risk medicines
  3. Improving medication safety at transitions of care

WHO Global Patient Safety Challenge

In 2020, the Commission was engaged by the Australian Government Department of Health to develop Australia’s response to the third WHO Global Patient Safety Challenge – Medication without harm. This document presented information on current medication safety programs and initiatives in Australia in 2020 and recommended priority actions to deliver a positive Response to the Challenge.

The Quality Use of Medicines objectives of Australia’s National Medicines Policy are consistent with these aims.

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Flagship areas

Polypharmacy

Monitoring polypharmacy and responding to inappropriate polypharmacy

Polypharmacy is the concurrent use of multiple medications. Although there is no standard definition, polypharmacy is often defined as the routine use of five or more medications. This includes over-the-counter, prescription and/or traditional and complementary medicines used by a patient. Inappropriate polypharmacy is the prescribing of multiple medicines inappropriately, or where the intended benefit of the medicine is not realised.

The goal should be to reduce inappropriate polypharmacy (irrational prescribing of too many medicines) and to ensure appropriate polypharmacy (rational prescribing of multiple medicines) based on best available evidence and considering individual patient factors and context.

Appropriate polypharmacy should be considered at initiation of a new treatment for the patient, and when the patient moves across different healthcare settings

High-risk medicines

Reducing harm from high-risk medicines

High-risk medicines are associated with significant patient harm or death if they are misused or used in error. Typically high-risk medicines include those with a narrow therapeutic index, and those that present a high risk when administered via the wrong route or when other medication management system errors occur. The high-risk medicines which are the focus of in Australia are insulin, opioid analgesics, anticoagulants and antipsychotics. 

High-risk medicines warrant special mechanisms and risk-reduction strategies to identify and intercept medication errors before they result in harm to the patient. In the acute sector, the APINCHS classification can assist clinicians to identify and focus on certain groups of medicines.

Transitions of care

Improving medication safety at transitions of care

Transitions of care occur when all or part of a patient’s care is transferred between healthcare locations, providers or levels of care within the same organisation, or the patient’s condition and care needs change.

At each point in transitions of care, the medication a patient was taking prior to the transition needs to be identified. At the next transition, the updated medication list should be communicated to the patient and future health care providers 

Common types of discrepancies at transitions of care include omission of medication (most common), wrong dose, drug-drug interactions, contraindication, duplication and failure to communicate changes.

Polypharmacy

Monitoring polypharmacy and responding to inappropriate polypharmacy

Polypharmacy is the concurrent use of multiple medications. Although there is no standard definition, polypharmacy is often defined as the routine use of five or more medications. This includes over-the-counter, prescription and/or traditional and complementary medicines used by a patient. Inappropriate polypharmacy is the prescribing of multiple medicines inappropriately, or where the intended benefit of the medicine is not realised.

The goal should be to reduce inappropriate polypharmacy (irrational prescribing of too many medicines) and to ensure appropriate polypharmacy (rational prescribing of multiple medicines) based on best available evidence and considering individual patient factors and context.

Appropriate polypharmacy should be considered at initiation of a new treatment for the patient, and when the patient moves across different healthcare settings

High-risk medicines

Reducing harm from high-risk medicines

High-risk medicines are associated with significant patient harm or death if they are misused or used in error. Typically high-risk medicines include those with a narrow therapeutic index, and those that present a high risk when administered via the wrong route or when other medication management system errors occur. The high-risk medicines which are the focus of in Australia are insulin, opioid analgesics, anticoagulants and antipsychotics. 

High-risk medicines warrant special mechanisms and risk-reduction strategies to identify and intercept medication errors before they result in harm to the patient. In the acute sector, the APINCHS classification can assist clinicians to identify and focus on certain groups of medicines.

Transitions of care

Improving medication safety at transitions of care

Transitions of care occur when all or part of a patient’s care is transferred between healthcare locations, providers or levels of care within the same organisation, or the patient’s condition and care needs change.

At each point in transitions of care, the medication a patient was taking prior to the transition needs to be identified. At the next transition, the updated medication list should be communicated to the patient and future health care providers 

Common types of discrepancies at transitions of care include omission of medication (most common), wrong dose, drug-drug interactions, contraindication, duplication and failure to communicate changes.