An inspection of Bantry General Hospital in Cork has identified "significant concerns" in relation to medication safety.

According to the Health Information and Quality Authority (HIQA), which carried out the inspection in March, "practices observed did not support safe medication practices and highlighted a lack of risk-reduction strategies in place to ensure safety with the management and the storage of anticoagulant medications".

Anticoagulants are medicines that stop the blood from clotting, e.g. warfarin and heparin.

HIQA noted that medications are the most commonly used intervention in healthcare, playing an essential role in the treatment of illness, the management of chronic conditions and the maintenance of health and wellbeing.

"As modern medicine continues to advance, increasing medication treatment options are available for. This advancement has brought with it an increase in the risks, errors and adverse events associated with medication use and as a result, medication safety has been identified internationally as a key area for improvement in all healthcare settings," it said.

The announced inspection in Bantry General was carried out on March 21 and it focused on systems in place for medication safety in the theatre department and a medical ward.

However, during the inspection, HIQA identified "significant concerns in relation to the overall leadership, governance and management of medication safety at Bantry General Hospital".

Risks included:
- The design of the medication prescription record did not reduce the risk of duplication and/or interaction with anticoagulant medications, or support standardised prescription practices for prescribers from other hospitals
-There was a lack of supporting medication management guidelines or policy on the prescribing and safe administration of anticoagulant medications
-Standardised and segregated storage of high and low-dose pre-mixed heparin was not in place, which did not support clear identification of heparin doses
-The ongoing lack of a clinical pharmacy service remained an outstanding issue identified by HIQA during the announced medication safety inspection at the hospital in 2016.

Following the inspection, HIQA immediately wrote to the hospital "to seek assurance as to how these specific risk issues would be comprehensively and speedily addressed".

The general manager of the hospital subsequently provided written assurance that "a number of remedial actions had been instigated to comprehensively address the identified risk within defined timelines".

These included:
-A review on the storage of anticoagulants in clinical areas with the introduction of separate storage facilities and removal of anticoagulants stored on drug trolleys
-The introduction of a high-risk labelling system for anticoagulants in all clinical areas
-The development and introduction of a hospital-wide policy to support staff in the management of high-risk medications within the next three months.

HIQA acknowledged that the hospital "had acted to strengthen medication safety through medication safety governance arrangements and implementing of some safety initiatives".

However, it added that there is still "scope for further improvement" and this requires "renewed focus for leadership and management at the hospital to ensure that medication safety is seen as a priority and that patients are protected from known and avoidable harm".

The HIQA report on Bantry General Hospital can be viewed here.