Many of the risks associated with each part of the medication management pathway can be avoided by using systems and processes that are designed to improve safety and are based on evidence from initiatives that have demonstrated significant benefit. These initiatives focus on addressing the common contributing factors to medication errors, which include1:
- Lack of knowledge of the medicine
- Lack of information about the patient
- Slips and memory lapses
- Transcription errors
- Failure in communication
- Lack of patient education
- Poor medicines distribution practices.
Medication safety initiatives should focus on systems and standardisation to reduce unnecessary variation, coupled with judicious use of tools and resources that improve knowledge and skills.
The actions and strategies described in this criterion aim to achieve safe and effective medicines use through:
- Best use of information and decision support tools in clinical decision-making
- Compliance and safety in medicines distribution and storage systems
- Targeting known risk areas (for example, high-risk medicines), and embedding processes, practices and tools within the organisation to prevent error
- Integration of work practices that underpin safe medication management (such as standardisation, monitoring and risk assessment)
- Using medication safety strategies and tools to create an environment for the best communication of medicine-related information (for example, using an MMP).
Actions within this criterion require health service organisations to:
- Make a variety of up-to-date and evidence-based medicine-related information and decision support tools available to clinicians
- Ensure the effectiveness of the supply chain in the safe delivery of medicines
- Ensure compliance with relevant requirements for maintaining the integrity of medicines, minimising wastage and disposing of medicines appropriately
- Implement strategies for safe and secure storage and selection of medicines, including high-risk medicines.
- Cohen MR, editor. Medication errors. 2nd ed. Washington (DC): American Pharmacists Association; 2007.