Taking stock: UK national antidote availability increasing, but further improvements are required

Bailey, GP; Rehman, Badshah; Wind, K; Wood, D.; Thanacoody, Ruben; Nash, Stephen; Archer, Jrh; Eddleston, Michael; Thompson, JP; Vale, J. A.; Thomas, Shl

doi:10.1136/ejhpharm-2015-000802

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…They also reported that only (24.3%) of the hospitals held all antidotes that were recommended to be available immediately, which only improved to (47.9%) after auditing and introducing a national guideline. They concluded that more efforts are required to ensure timely access to other antidotes ( Bailey et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Can’t find the antidote: A root cause analysis

2022

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Background: In a series of cases that came to be recognized as a national methanol outbreak, an incident of delay in allocation and treatment with the antidote fomepizole is described with aim of sharing a learning experience.Method: A team of 16 members was formed to conduct a Root Cause Analysis (RCA), which included multiple individual interviews with the stakeholders and inspection visits to the area.Results: Root causes: The restocking process was unclear and inconsistent and specifically lacked a restocking policy for antidotes, inappropriate labeling and area design, and a sound-alike between fomepizole and omeprazole. Contributing factors included: unsuitable restocking practice and lack of training in using the pharmaceutical electronic inventory system. Corrective actions were recommended and implemented.Conclusion: Management of antidotes in large healthcare systems requires a team effort to ensure appropriate and timely availability in emergency poisoning cases. This RCA identified important areas for improvement that could be insightful to other institutions in preventing similar vulnerabilities and is unique in describing the details of system improvements that can have a large impact on patient safety.

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Section: Discussionmentioning

confidence: 99%

Can’t find the antidote: A root cause analysis

2022

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“…If the antidote was not stocked, the estimated time taken to source this from another hospital was also recorded. Data were compared with the previous national audits carried out in 2010 and 2014 15 16. Data from the 2007 audit were not directly comparable due to differences in question phrasing and data collection.…”

Section: Methodsmentioning

confidence: 99%

“…Audits have been undertaken following the release of each update to assess changes in antidote holdings and guide future updates. These were carried out in 2007 (Nash, Dines & Dargan, unpublished), 201015 and 2014 16. The most recent audit in 2014 showed that, despite improvements, there remains substantial variability in the availability of antidotes, in particular those in category C. The aim of this study was to provide a current picture of compliance with the 2017 UK antidote guidelines.…”

Section: Introductionmentioning

confidence: 99%

National audit of antidote stocking in UK emergency departments

et al. 2019

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BackgroundPrevious audits of antidote stocking in UK hospitals have demonstrated variable but improving compliance with joint Royal College of Emergency Medicine and National Poisons Information Service guidance on antidote availability in emergency departments. The guidance was updated in 2017.AimTo provide a current picture of compliance with the 2017 antidote guidance and compare this to previous audits.MethodsQuestionnaires were distributed to all hospitals in the UK with an emergency department via medicines information and regional pharmacy procurement networks. Data were collected on availability and stock levels of category A (immediately available) and category B (available within 1 hour) antidotes. Additionally, data were collected on holdings of category C (held supra-regionally) antidotes and arrangements for sourcing these if not stocked locally.Results233 hospitals were surveyed and 178 replies (76.4%) were received. There were 73 hospitals (41.7%) fully compliant with guidance for category A, 34 hospitals (19.1%) for category B and 18 hospitals (10.1%) for both categories A and B antidotes. Few hospitals stocked category C antidotes (1.1%–34.8%). Evidence of formalised regional holding arrangements for category C antidotes, as advised in the guidance, was noted in some areas but many regions remain without such agreements.ConclusionsMost hospitals remain not fully compliant with stocking recommendations for categories A and B antidotes, with limited recent improvement. Category C antidotes are stocked by few hospitals although awareness of where these can be sourced appears to be increasing. Emergency departments should review their antidote stocking arrangements to ensure compliance with guidance. Formal arrangements for stocking of the more rarely used category C antidotes at a regional level are also required, where not already in existence, in order to assure their availability in an equitable way across the country.

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“…The quantity of each antidote based on international studies and number of cases and antidote strength. [8][9][10][11] The three classes are distributed at the hospital and primary center. The maximum distance between each institution was not exceeding one traveling time that's equal to 100 kg as explained in appendix A, B and C. The project was written in several parts that are included; the initial phase, planning phase, execution phase, monitoring and controlling aspect.…”

Section: Education and Trainingmentioning

confidence: 99%

“…Several studies conducted to explore the antidote of poisoning with quality and quantity manner. [8][9][10][11] To the best of author's knowledge, there is no any publication about the antidote distribution system in Saudi Arabia or Gulf and Middle East countries. The goal of this review is to explore the national antidote of the poisoning distribution system at the Ministry of Health institutions in the Kingdom of Saudi Arabia.…”

Section: Introductionmentioning

confidence: 99%

National Antidote of Poisoning Distribution System: New Initiatives in Saudi Arabia

Alomi¹,

Al-Najjar²,

Alghamdi³

et al. 2019

IJPCS

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Objective: To declare the national antidote of poisoning distribution system as new initiatives in the Kingdom of Saudi Arabia. Methods: It is a new initiative project, the national antidote of poisoning distribution system. The project drove the antidote of poisoning distribution guidelines and the international business model, pharmacy project guidelines project management institution guidelines of a new project. The initiative project is written through project management professionals and consisted of several parts, including the initial phase, the planning phase, the execution phase and the monitoring and controlling phase. Results: The antidote of poisoning distribution system with a defined vision, mission and goals was initiated. The services had various advantages with clinical and economic impacts on patients and healthcare services as illustrated in the review. The extension of the project was assured by risk management elements description. Furthermore, the monitoring and controlling of the services was demonstrated. The conversion to operation project though closing project stage was revealed in the analysis. Conclusion: The national antidote of poisoning distribution system is new initiative project and is considered as a part of the management of poisoning. There are multiple locations of antidote distribution services suggested and it is highly required in the Kingdom of Saudi Arabia.

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Taking stock: UK national antidote availability increasing, but further improvements are required

Cited by 6 publications

References 6 publications

Can’t find the antidote: A root cause analysis

Can’t find the antidote: A root cause analysis

National audit of antidote stocking in UK emergency departments

National Antidote of Poisoning Distribution System: New Initiatives in Saudi Arabia

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