Exploration of prescribing error reporting across primary care: a qualitative study.

OBJECTIVES: To explore barriers and facilitators to prescribing error reporting across primary care. DESIGN: Qualitative semi-structured face-to-face and telephone interviews were conducted to explore facilitators and barriers to reporting prescribing errors. Data collection and thematic analysis were informed by the COM-B model of behaviour change. Framework analysis was used for coding and charting the data with the assistance of NVivo software (V.12). General and context specific influences on prescribing error reporting were mapped to constructs from the COM-B model (ie, capability, opportunity and motivation). SETTING: Primary care organisations, including community pharmacy, general practice and community care from North East England. PARTICIPANTS: We interviewed a maximal variation purposive sample of 25 participants, including prescribers, community pharmacists and key stakeholders with primary care or medicines safety roles at local, regional and national levels. RESULTS: Our findings describe a range of factors that influence the capability, opportunity and motivation to report prescribing errors in primary care. Three key contextual factors are also highlighted that were found to underpin many of the behavioural influences on reporting in this setting: the nature of prescribing; heterogeneous priorities for error reporting across and within different primary care organisations; and the complex infrastructure of reporting and learning pathways across primary care. Findings suggest that there is a lack of consistency in how, when and by whom, prescribing errors are reported across primary care. CONCLUSIONS: Further research is needed to identify cross-organisational and interprofessional consensus on agreed reporting thresholds and how best to facilitate a more collaborative approach to reporting and learning, that is, sensitive to the needs and priorities of disparate organisations across primary care. Despite acknowledged challenges, there may be potential for an increased role of community pharmacy in prescribing error reporting to support future learning.

Evaluating the effectiveness of digital communication within the National Medication Safety Network for England.

OBJECTIVES: The medication safety officer (MSO) role was created following a patient safety alert, with an action for MSOs to be active participants in a national network in England, which included regular online webinar meetings and an online forum. The aim of the study was to assess the effectiveness of digital platforms in facilitating interaction and communication by the MSO network. The objectives were to establish the proportion of MSOs who interact through monthly webinars and the online forum. A secondary objective was to identify barriers and facilitators for engaging digitally within the MSO network. METHODS: An online survey was used alongside semistructured interviews. The online survey was disseminated to all 400 MSOs registered with the UK Department of Health Central Alerting System from December 2018 to February 2019. Interviewees were identified purposively through snowball sampling and voluntarily through the survey. RESULTS: 84 MSOs responded to the survey (21% response rate) and 10 participated in the semistructured interviews. The majority of the respondents were pharmacists (79/84, 94%) from NHS large healthcare providers (44/84, 52%). MSO respondents (61/84, 73%) joined the monthly webinar and 47/84 (56%) believed the webinar was useful for networking. Ten (12%) did not attend the webinars due to technical difficulties or lack of time. The online forum was used less frequently, with a third (27/84, 32%) that had never used it. CONCLUSIONS: Digital communications through webinars and online forums were perceived by respondents as a way to facilitate networking but require a robust information technology infrastructure that can be accessed without difficulty. User-friendly platforms can help the MSO network achieve critical mass and greater interaction, allowing timely access to information.

Prescribing error reporting in primary care: a narrative synthesis systematic review.

Prescribing errors can cause avoidable harm to patients. Most prescriptions originate in primary care, where medications tend to be self-administered and errors have the most potential to cause harm. Reporting prescribing errors can identify trends and reduce the risk of the reoccurrence of incidents; however, under-reporting is common. The organisation of care and the movement of prescriptions from general practice to community pharmacy may create difficulties for professionals to effectively report errors. This review aims specifically to identify primary research studies that examine barriers and facilitators to prescription error reporting across primary care. A systematic research of the literature was completed in July 2019. Four databases (PubMed/Medline, Cochrane, CINAHL and Web of Science) were searched for relevant studies. No date or language limits were applied. Eligible studies were critically appraised using the Mixed Methods Appraisal Tool, and data were descriptively and narratively synthesised. Ten articles were included in the final analysis. Seven studies considered prescription errors and error reporting within general practice and three within a community pharmacy setting. Findings from the included studies are presented across five themes, including definition of an error, prescribing error reporting culture, reporting processes, communication and capacity. Healthcare professionals appreciate the value of prescription error reporting, but there are key barriers to implementation, including time, fear of reprisal and organisation separation within primary care.