NHS Patient Safety – Medication

How can Pharmaceutical Companies contribute to improving NHS Patient Safety?

They can demonstrate ‘added value’ , for example, by either offering products which contribute directly to making the administration of medicines safer by helping to reduce:-

• Making the drug up to the wrong strength
• Using the wrong diluent
• Microbial or other forms of contamination
• Labelling errors
• Administration by the incorrect route by clearer design/packaging of the product

The products which are commonly offered as part of a compounding service include:-

• Cytotoxics
• Antibiotics
• Inotropes
• Potassium solutions
• TPN
• Unlicensed medicines

In addition, the provision of non-promotional training/educational services to healthcare professionals in the form of Continuing Professional Development events and nurse advisor teams helps to educate NHS staff on how to administer medicines more

• Confidently
• Accurately
• Competently

The Department of Health (DH) has issued the following list of ‘Never Events’ for 2012-13. The list is circulated to a wide range of NHS managers, clinicians and healthcare professional allied to medicine.

The document authors are the DH’s Patient Safety and Investigations unit. The purpose of the document is to highlight certain events which are deemed to be very serious risks to the standard of care to patients, but most importantly avoidable.

The document forms part of the wider DH’s Patient Safety Agenda policy and should be read in conjunction with the NHS Standards Contract for organisations providing services to the NHS

1. Wrong site surgery
2. Wrong implant/prosthesis
3. Retained foreign object post-operation
4. Wrongly prepared high-risk injectable medication
5. Maladministration of potassium-containing solutions
6. Wrong route administration of chemotherapy
7. Wrong route administration of oral/enteral treatment
8. Intravenous administration of epidural medication
9. Maladministration of Insulin
10. Overdose of midazolam during conscious sedation
11. Opioid overdose of an opioid-naïve patient
12. Inappropriate administration of daily oral methotrexate
13. Suicide using non-collapsible rails
14. Escape of a transferred prisoner
15. Falls from unrestricted windows
16. Entrapment in bedrails
17. Transfusion of ABO-incompatible blood components
18. Transplantation of ABO incompatible organs as a result of error
19. Misplaced naso- or oro-gastric tubes
20. Wrong gas administered
21. Failure to monitor and respond to oxygen saturation
22. Air embolism
23. Misidentification of patients
24. Severe scalding of patients
25. Maternal death due to post partum haemorrhage after elective Caesarean  section

Source: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132352.pdf

You can read the whole document if you wish, but the indicators within the specific areas where the Pharmaceutical Industry has opportunities to work in conjunction with the NHS includes:-

1. Wrongly prepared high-risk injectable medication

• Death or severe harm as a result of a wrongly prepared high-risk injectable       medication.
• High-risk injectable medicines are identified using the NPSA’s risk assessment tool1. A list of high-risk medicines has been prepared by the NHS Aseptic Pharmacy Services Group using this tool2. Organisations should have their own list of high-risk medications for the purposes of the “never event” policy, which may vary from the NHS Aseptic Pharmacy Services Group list, depending on local circumstances.
• A high risk injectable medicine is considered wrongly prepared if it was not; o prepared in accordance with the manufacturer’s Specification of Product Characteristics;

1 NPSA High Risk Medication Risk Assessment Tool, 2007, available at

http://www.nrls.npsa.nhs.uk/EasySiteWeb/getresource.axd?AssetID=60097&type=full&servicet ype=Attachment

2 Pharmaceutical Aseptic Services Group. Example risk assessment of injectable medicines. 2007. Available at http://www.civas.co.uk/

• This event excludes any incidents that are covered by other “never events”.
• Where death or severe harm cannot be attributed to incorrect preparation, treat as a Serious Untoward Incident.

5. Maladministration of potassium-containing solutions

• Death or severe harm as a result of maladministration of a potassium-containing solution.

Maladministration refers to;

• selection of strong potassium solution instead of intended other medication,
• wrong route administration, for example a solution intended for central venous catheter administration given peripherally,
• infusion at a rate greater than intended.

Setting: All healthcare settings.

Guidance: - Patient safety alert – Potassium chloride concentrate solutions, 2002 (updated 2003), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59882

6. Wrong route administration of chemotherapy

Intravenous or other chemotherapy (for example, vincristine) that is correctly prescribed but administered via the wrong route (usually into the intrathecal space).

 

Setting: All healthcare premises.

Guidance: - HSC2008/001: Updated national guidance on the safe administration of intrathecal chemotherapy, available at http://www.dh.gov.uk/en/publicationsandstatistics/lettersandcirculars/healthservicecirculars/dh_ 086870 - Rapid Response Report NPSA/2008/RRR004 using vinca alkaloid minibags (adult/adolescent units), available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59890

7. Wrong route administration of oral/enteral treatment

Death or severe harm as a result of oral/enteral medication, feed or flush administered by any parenteral route.

Setting: All healthcare settings.

Guidance: - Patient Safety Alert NPSA/2007/19 – Promoting safer measurement and administration of liquid medicines via oral and other enteral routes, 2007, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59808

8. Death or severe harm as a result of intravenous administration of epidural medication.

• A broader “never event” covering intravenous administration of intrathecal medication or The “never events” list 2012/13 9 intrathecal administration of intravenous medication is intended once the deadlines for Patient Safety Alert 004A and B actions have passed.

 Setting: All healthcare premises.

Guidance: - Patient Safety Alert NPSA/2007/21, Safer practice with epidural injections and infusions, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59807 – Safer spinal (intrathecal), epidural and regional devices – Parts A and B, available at http://www.nrls.npsa.nhs.uk/resources/?EntryId45=65259

9. Maladministration of Insulin

Death or severe harm as a result of maladministration of insulin by a health professional. Maladministration in this instance refers to when a health professional

• uses any abbreviation for the words ‘unit’ or ‘units’ when prescribing insulin in writing,
• issues an unclear or misinterpreted verbal instruction to a colleague,
• fails to use a specific insulin administration device e.g. an insulin syringe or insulin pen to draw up or administer insulin, or
• fails to give insulin when correctly prescribed.

Setting: All healthcare settings.

Guidance: - Rapid response report – Safer administration of insulin, 2010, available at http://www.nrls.npsa.nhs.uk/alerts/?entryid45=74287 - NHS Diabetes – Safe use of insulin, 2010, available at http://www.diabetes.nhs.uk/safe_use_of_insulin/ - NHSIII Toolkit – Think Glucose, 2008, available at http://www.institute.nhs.uk/thinkglucose - NHS Diabetes guidance – The Hospital Management of Hypoglycaemia in Adults with Diabetes Mellitus, 2010, available at http://www.diabetes.nhs.uk/document.php?o=1037

19. Misplaced naso- or oro-gastric tubes

Death or severe harm as a result of a naso- or oro-gastric tube being misplaced in the respiratory tract.

Setting: All healthcare premises.

Guidance: - Patient safety alert – Reducing harm caused by misplaced nasogastric feeding tubes, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59794 - Patient safety alert – Reducing harm caused by misplaced naso and orogastric feeding tubes in babies under the care of neonatal units, 2005, available at http://www.nrls.npsa.nhs.uk/resources/?entryid45=59798&q=0%c2%acnasogastric%c2%ac

Please visit the20:20Selection website if you have found this article helpful, as we regularly update the articles in our Factsheet section

http://www.2020selection.co.uk

Key Account Manager Roles – Catching a KAM

Many articles have been written about the best way to engage with our customers in the NHS. How best to partner with this new breed, made up of payers, commissioners, and medicines management gurus. How best to tap into their agenda. In fact, many careers have been built on telling us just how to sell to our customers, and an awful lot of consultancy fees have been paid to experts so that we can all be scared to death about this ‘new’ customer group who we are told work hidden away, been firmly shut doors in an increasingly complex and confusing NHS maze.

In my simple world view, yes, of course we do need to speak the same language as our customers, but we also need to ensure that we are getting the balance right, to ensure that our customer partnerships are mutually beneficial. We need to be truly customer focused, but we also need to achieve the win:win equilibrium, to avoid promising the world in value added services for very little commercial return.

Over the last few years, Key Account Management has been the new pharma industry term that seems to be bandied about on a daily basis. It is used often and widely and it seems to mean different things to different people in different companies. Every hiring manager seems to be looking for the elusive KAM. Does it mean a hospital representative? Does it mean an NHS Liaison Manager? Is it a bit of both? Or is it just a very good salesperson with the right attitude, the right skills and the common sense to convince key influential customers to sit round a table, to weigh up the pros and cons, and to agree on decisions that will help them to achieve their desired outcomes, but that will also grow product sales for their company?

In many ways, Key Account Management is a philosophy; a way of thinking, rather than some magical process. Account plans and systems can of course help to keep business on track, but they cannot be the golden ticket on their own. People still, and always will, buy from people.  Outstanding KAM’s need to be outstandingly talented sales people. In the ‘good old’ days, when sales people were autonomous, and they had full accountability for their results, the successful ones managed their own business and they managed it well. Naturally, they identified and involved all key stakeholders, naturally they engaged with clinicians, and non clinicians alike, and naturally they engaged the people who ultimately held the purse strings. They were unblocking the clinical and funding barriers that KAM’s and Market Access Manager’s do today, whilst always remembering to sell.

This breed are driven, competitive, innovative, competitive, hardworking, flexible responders to change and above all, as superb net workers and communicators, they can be relied upon to consistently achieve results.

At 20:20 Selection Limited, we know that recruitment agencies are mainly fishing from the same pond. The skill we use to catch the KAM’s is to recognise the specific species, and to know which bait to use.

Top 10 Interview Questions

Too many job seekers stumble through interviews as if the questions are coming out of left field. But many interview questions are to be expected. Study this list and plan your answers ahead of time so you’ll be ready to deliver them with confidence.

What Are Your Weaknesses?
This is the most dreaded question of all. Handle it by minimising your weakness and emphasising your strengths. Stay away from personal qualities and concentrate on professional traits: “I am always working on improving my communication skills to be a more effective presenter. I recently joined Toastmasters, which I find very helpful.”

Why Should We Hire You?
Summarise your experiences: “With five years’ experience working in the financial industry and my proven record of saving the company money, I could make a big difference in your company. I’m confident I would be a great addition to your team.”

Why Do You Want to Work Here?
The interviewer is listening for an answer that indicates you’ve given this some thought and are not sending out CVs just because there is an opening. For example, “I’ve selected key companies whose mission statements are in line with my values, where I know I could be excited about what the company does, and this company is very high on my list of desirable choices.”

What Are Your Goals?
Sometimes it’s best to talk about short-term and intermediate goals rather than locking yourself into the distant future. For example, “My immediate goal is to get a job in a growth-oriented company. My long-term goal will depend on where the company goes. I hope to eventually grow into a position of responsibility.”

Why Did You Leave (Or Why Are You Leaving) Your Job?
If you’re unemployed, state your reason for leaving in a positive context: “I managed to survive two rounds of corporate downsizing, but the third round was a 20 percent reduction in the workforce, which included me.”

If you are employed, focus on what you want in your next job: “After two years, I made the decision to look for a company that is team-focused, where I can add my experience.”

When Were You Most Satisfied in Your Job?
The interviewer wants to know what motivates you. If you can relate an example of a job or project when you were excited, the interviewer will get an idea of your preferences. “I was very satisfied in my last job, because I worked directly with the customers and their problems; that is an important part of the job for me.”

What Can You Do for Us That Other Candidates Can’t?
What makes you unique? This will take an assessment of your experiences, skills and traits. Summarise concisely: “I have a unique combination of strong technical skills, and the ability to build strong customer relationships. This allows me to use my knowledge and break down information to be more user-friendly.”

What Are Three Positive Things Your Last Boss Would Say About You?
It’s time to pull out your old performance appraisals and boss’s quotes. This is a great way to brag about yourself through someone else’s words: “My boss has told me that I am the best designer he has ever had. He knows he can rely on me, and he likes my sense of humour.”

What Salary Are You Seeking?
It is to your advantage if the employer tells you the range first. Prepare by knowing the going rate in your area, and your bottom line or walk-away point. One possible answer would be: “I am sure when the time comes, we can agree on a reasonable amount. In what range do you typically pay someone with my background?”

If You Were an Animal, Which One Would You Want to Be?
Interviewers use this type of psychological question to see if you can think quickly. If you answer “a bunny,” you will make a soft, passive impression. If you answer “a lion,” you will be seen as aggressive. What type of personality would it take to get the job done? What impression do you want to make?

Source:  Monster.co.uk

20:20 Selection in On Target Publication

Healthcare recruitment consultancy 20:20 Selection Ltd is expanding with new premises and two new staff members.

Managing Director Karen Forshaw commented: “We have always considered it essential that the working environment should add value to our core function of recruiting for the pharmaceutical and medical industry. In our new location we are better prepared to address the challenges ahead.”

Managing Director Karen Forshaw commented: “We have always considered it essential that the working environment should add value to our core function of recruiting for the pharmaceutical and medical industry. In our new location we are better prepared to address the challenges ahead.”

New Recruitment Consultant Sarah Taylor has worked in the Sales and Marketing department of a private hospital, and has recruitment experience from earlier roles. She said: “20:20 Selection Ltd is a leading player in a fast-paced industry, with a unique team ethos focused on delighting the customer. It was these key features that attracted me to the company and I am delighted to be part of its success story.”

Sarah Byrom joins as Recruitment Administrator, having previously been a Recruitment Assistant for a computer game company. “Working in recruitment requires efficient and effective administration support,” she said. “I understand the importance of a slick programme which ultimately benefits our most important asset, the customer.”

Source: On Target

http://www.ontargetmag.com/article.aspx?issueID=140&articleID=1065

New Service at 2020 Selection

2009 sees the introduction of WebCam technology at 20:20 Selection Ltd making interviewing and coaching more convenient for you!

Our new building offers many sophisticated facilities such as a state of the art Conference and  Meeting room complete with an interaction video link from which clients can communicate and maximise their busy working schedules.

We feel the benefits of video link is endless, it offers clients in the field, the opportunity to attend important board meetings in real time, and allows prospective candidates the opportunity of having  direct dialogue with our consultants when they are unable to travel to our offices for interview.

Contact us on 0845 026 2020 to learn more about how we coach our candidates and the latest vacancies in the medical industry.