Clinical Effectiveness Priorities

Accordion

Our priorities are grouped into three areas. The first area relates to clinical effectiveness.

Click on each of the titles below to learn more and then vote for which of the three you think we should prioritise.

Why this has been chosen as a priority?

Up to 5% of pathology requests have samples rejected due to avoidable circumstances including a mismatched sample and form, unlabelled samples or issues with the sample itself, such as being haemolysed. This can result in delays to patient care or the requirement for the sample to be retaken.

The aim is to reduce the number of rejected samples thereby reducing the impact on patients, those requesting samples and the laboratory teams.

What are we going to do?

  • A ‘use of pathology services’ policy will be published alongside a publicity campaign to ensure that all users are aware of the procedures for sending samples to pathology
  • Targeted campaigns will be conducted to improve sample taking, recording, and requesting in areas where the issue is most prevalent, these will include written/visual information such as posters and also outreach/education events
  • Where a particular issue is identified in a specific area we will work with the area to identify any further preventative actions that can be taken
  • Data will continue to be analysed to assess whether these actions result in improvements

Why has this been chosen as a priority?

Nationally, there are a consistently high number of insulin prescription and administration errors.  This is both a medical and nursing responsibility.  Administration errors are the most frequent errors related to medications. Improvement in these areas present an opportunity to detect and prevent errors before they occur.

What are we going to do?

  • Increase uptake of the safe use of insulin training and reintroduce the competency assessment tool every three years to support revalidation for midwives and registered nurses, and one yearly for community support workers
  • Encourage doctors to attend regular training sessions provided by the diabetes team on safe use and prescription of insulin
  • Inclusion of the reports on insulin errors and hypoglycaemia in the governance meetings
  • Early referral to the diabetes team of patients requiring a diabetes management review
  • Continued participation in the national awareness campaign on insulin safety and hypoglycaemia

Why is this a priority?

There have been incidents reported nationally where patients have been prescribed and administered the wrong dose of paracetamol based on their weight. Paracetamol, although thought to be a “safe drug”, is of higher risk to particular patients; especially those of low weight, with liver impairment and those on multiple medicines. The aim is to raise awareness of the prescribing risks of paracetamol and the relevance of patients’ weight and other risk factors including liver function.

What are we going to do?

  • Collect baseline data to review current prescribing trends for paracetamol which will be used to test our improvement initiatives
  • Set up a multidisciplinary group to focus on the issues around paracetamol prescribing and administration
  • To raise awareness of the prescribing risks associated with paracetamol and the relevance of patients’ weight
  • Develop educational materials and ensure all healthcare professionals involved in the prescribing and administering of paracetamol have the relevant training
  • Education and feedback to be provided on wards for healthcare professionals and during pharmacy prescribing teaching sessions for doctors
  • Ensure the new electronic prescribing system includes advice for oral paracetamol prescribing that prompts weekly documentation of a patient’s weight and consideration of the risk of liver toxicity when their weight is less than 50kg
  • Review available equipment on wards for weighing patients to ensure that accurate weights are obtained wherever possible
  • Review national guidance (and keep updated) for paracetamol prescribing
  • Review prompts and alerts/resources to support safer (electronic) prescribing
  • Review use of paracetamol combination products (particularly at discharge) to reduce duplication of paracetamol dosing