Therapies in ACS: the pitfalls of prescribing
Acute coronary syndrome (ACS) is a significant health burden in NHS Lanarkshire.1 Although innovative anticoagulant and antiplatelet therapies have aided treatment of ACS in recent years, these drugs can cause prescribing errors.2 This was identified as an area of improvement at University Hospital Wishaw following recent adverse events and continued use of out-of-date ACS guidelines.3
The aim of the project was to improve prescribing of anticoagulant and antiplatelet therapies in patients presenting with ACS. Data were collected and analysed from patients presenting to the medical receiving unit with ‘chest pain’ and prescribing errors related to ACS loading treatment were recorded. DATIX incidents related to anticoagulant/antiplatelet prescribing were also analysed pre- and post-intervention.
An ACS infographic was designed to increase prescribing awareness and help reduce errors. This was displayed in all clinical areas and nursing medication trolleys. Education sessions on prescribing safety and medication types were also delivered to all medical and nursing staff.
Two quality improvement cycles were conducted in April–June 2019 and July–September 2019. DATIX incidents decreased from 1.3 per month pre-intervention to 0 per month post intervention and this trend was mirrored in DATIX incidents related to anticoagulant prescribing as a whole. Patients who had a prescribing error during ACS loading treatment decreased from 36% in cycle 1 (8/22) to 29% in cycle 2 (6/21).
In conclusion, education and a simple infographic can reduce the number of adverse incidents and prescribing errors in patients presenting with ACS. Further work will focus on wider awareness of these issues as the project is launched across other hospitals in the health board.
Conflicts of interest
None declared.
- © Royal College of Physicians 2020. All rights reserved.
References
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- Information Services Division
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- Ali MAS
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- NHS Lanarkshire
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