National audit of antidote stocking in UK emergency departments.

accident & emergency medicine audit audit, self-inspection clinical pharmacy protocols & guidelines

Journal

European journal of hospital pharmacy : science and practice
ISSN: 2047-9956
Titre abrégé: Eur J Hosp Pharm
Pays: England
ID NLM: 101578294

Informations de publication

Date de publication:
07 2021
Historique:
received: 15 05 2019
revised: 20 06 2019
accepted: 26 06 2019
entrez: 24 6 2021
pubmed: 25 6 2021
medline: 2 4 2022
Statut: ppublish

Résumé

Previous 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. To provide a current picture of compliance with the 2017 antidote guidance and compare this to previous audits. Questionnaires 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. 233 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. Most 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.

Sections du résumé

BACKGROUND
Previous 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.
AIM
To provide a current picture of compliance with the 2017 antidote guidance and compare this to previous audits.
METHODS
Questionnaires 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.
RESULTS
233 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.
CONCLUSIONS
Most 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.

Identifiants

pubmed: 34162673
pii: ejhpharm-2019-001988
doi: 10.1136/ejhpharm-2019-001988
pmc: PMC8239273
doi:

Substances chimiques

Antidotes 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

217-222

Informations de copyright

© European Association of Hospital Pharmacists 2021. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

James T Harnett (JT)

Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK j.harnett@nhs.net.

Sheena Vithlani (S)

London Medicines Information Service, London North West Healthcare NHS Trust, London, UK.

Shabnam Sobhdam (S)

London Medicines Information Service, London North West Healthcare NHS Trust, London, UK.

James Kent (J)

NHS Specialist Pharmacy Service, UK.

Lindsay McClure (L)

NHS National Procurement, Edinburgh, UK.

Simon Hl Thomas (SH)

National Poisons Information Service (Newcastle Unit), Newcastle Hospitals NHS Trust, Newcastle, UK.
Institute of Cellular Medicine, Newcastle University, Newcastle, UK.

Paul I Dargan (PI)

Department of Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Faculty of Life Sciences and Medicine, King's College London, London, UK.

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