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Friday Five (July 23, 2021)

This edition of the Friday Five includes articles on Safety IQ documentation, shared learning to balance safety and efficiency, and talking to kids about their medicine.

Safety IQ and Documentation 

As of June 1, 2021, community pharmacies began recording medication incidents and near-miss events to their online reporting platforms. The Medication Incident and Near-Miss Event Practice Direction outlines what information must be documented beyond medication incidents and near-miss events. For a quick guide to all the requirements for documentation, please see the following resource: https://cphm.ca/resource/documentation-quick-guide-for-safety-iq/

Documentation is important from two different perspectives: measuring and monitoring the effectiveness of process or procedure changes and for regulatory compliance and review 

In terms of measuring and monitoring safety improvements, your pharmacy must document the improvement plans created in response to individual incidents, trends or patterns detected by staff or managers, and in response to the pharmacy’s Safety Self-Assessment. Without documentation of your plans, it is impossible to assess if your changes have reduced the chances of patient harm. Measuring and monitoring is a key component of continuous quality improvement. 

Secondly, documentation is key to accountability and regulatory compliance. The College inspection process is in place to protect the public interest and compliance with Safety IQ is a key component of College accountability to the public. 

In the rare event the College must launch an investigation relating to a complaint by a member of the public, a colleague, or the College, documentation that you followed the requirements of the Medication Incident and Near-Miss Event Practice Direction is key evidence that will be collected.  

Because pharmacies are using a variety of reporting platforms each with different capabilities, there is a potential to miss a step in the documentation process. The Medication Incident Reporting Platform Criteria requires platforms to provide online tools for documenting improvement plans; however, platform providers have diverse approaches to other forms of documentation.  

During an investigation, the pharmacy must be able to provide incident information such as  

  • patient’s name;  
  • prescription number;  
  • medication(s) involved in the incident; 
  • description of the incident; 
  • action taken by the pharmacy; and  
  • conversations of those involved including patient, prescriber, and pharmacy staff.  

Some of these data fields, such as incident descriptions and the medication involved, are required for all platform providers as this information is exported to the National Incident Data Repository. However, some reporting platforms include additional data fields, such as patient name and prescription number, for use by the pharmacy. Because all requirements must be available for regulatory review if requested, your pharmacy must ensure that each incident and the improvement plans put in place because of the incident, are somehow collated (cross-referenced) so there is a complete record of the incident and the outcome attached to the patient’s record. 

If the prescription number is not included in the online incident report, then the pharmacy must develop a record-keeping procedure for the pharmacy. This might include, for example, noting the incident number from the online platform directly in the patient record or using an incident log. 

Additionally, pharmacies must document conversations/dialogue with individuals involved or affected by the incident – patients, prescribers and pharmacy staff. This requirement is the same as in the previous Medication Incident and Near-Miss Event Practice Direction. Some platforms may have online tools to document conversations with the patient, prescriber and staff while others may not.  No matter which platform you use, the pharmacy must have a consistent and reliable process for documenting these communications either via paper or electronic copy. As always, pharmacies must protect all personal health information as per The Personal Health Information Act (PHIA). 

Please see the Safety IQ Quick Guide: Documentation for a resource to use in your pharmacy:
https://cphm.ca/resource/documentation-quick-guide-for-safety-iq/  

If you have questions about documentation, please email safetyiq@cphm.ca 

 

Share Learning: Balancing Safety and Efficiency in Community Pharmacy 

The College implemented Safety IQ on June 1, 2021, as the continuous quality improvement (CQI) program for community pharmacies in Manitoba. An important aspect of CQI in your pharmacy is proactively reviewing processes and procedures to reduce the chance of patient harm in the future. Shared learning and open discussion of dispensary practices and patient safety concerns is a key component of CQI and ISMP Canada Safety Bulletins are one way to get the conversation started. 

The data your pharmacy sends to the National Incident Data Repository (NIDR) hosted by ISMP Canada is analyzed by medication safety experts who share learning with healthcare professionals across the country. The recent ISMP Safety Bulletin, Balancing Safety and Efficiency in Community Pharmacy, is an example of analysis and recommendations resulting from community pharmacies across Canada sharing their medication incident experiences.  

The bulletin reviews six areas where measures intended to make the prescription process faster contributed to medication incidents. One of the problematic processes reviewed is a common practice in pharmacies – copying a previous prescription file. Although this practice can make the process more efficient, there is also an increased risk of error. The bulletin recommends that pharmacies limit the copy function to unchanged new prescriptions only and entering altered or updated prescriptions as new prescriptions.  

By sharing and reviewing the ISMP Safety Bulletin as a team, your pharmacy may consider changes in processes to improve the safety of your pharmacy and reduce the chance of a medication error for your patients.  

Consultation Closed: Pharmacist Prescribing for Uncomplicated Cystitis 

The consultation on pharmacist prescribing for uncomplicated cystitis officially closed on July 9, 2021. The College would like to thank all registrants who provided feedback on the proposed amendment. The College is committed to an open and transparent consultation process, and Council will consider all of your valuable comments and feedback. 

Talking to Kids about Their Medicine 

Institute for Safe Medication Practices Canada (ISMP) developed a safety resource to help children and youth learn what questions they should ask when receiving medication from their health team.  

Involving children in their own care helps give them a voice to speak up when they have concerns. 

The resource, titled 5 Questions to Ask About My Medicine, includes a handout and an implementation guide. Pharmacists can use the handout as a checklist to review medications with pediatric patients at every visit and encourage children to keep a copy of the handout in their room, on the fridge, or somewhere visible in the home.

For more information on this resource and the full ISMP Safety Bulletin, please click here.

 Professional Development Opportunities & Events  

  • Community Connector Training Workshop: Identifying and Referring Socially Isolated Older Adults 
    July 29, 2021 7:00 p.m.
    Register here.
  • Pear Healthcare Injection Training Workshop
    August 12, 2021
    For more information and to enroll, click here.
  • Pharmacists Manitoba Fall Conference
    September 18, 2021 
    View the full program and register here
  • ISMP Medications Safety Considerations for Compliance Packaging E-learning Module 
    Complete the module here.