The National Patient Safety Agency (NPSA) has issued guidance for all NHS organisations across England and Wales, aimed at reducing the risk of harm or death through the incorrect use of loading doses.
This latest Rapid Response Report (RRR) asks NHS organisations to ensure that:
• Risk assessments take place of all medicines that are likely to cause harm if loading doses and subsequent maintenance doses are not prescribed and administered correctly. Critical medicines include: warfarin, amiodarone, digoxin, phenytoin and any other medicines identified locally.
• There is effective communication regarding loading dose and subsequent maintenance dose regimens when prescribing, dispensing or administering critical medicines. This includes handover of patients. Tools such as loading dose work sheets, loading dose prescription charts, handover and clinical protocols, and patient-held information should be considered.
• Clinical checks are performed by medical, nursing and pharmacy staff (when available) so that loading and maintenance doses are correct. Appropriate information should be available to support these checks.
• Healthcare professionals in the community are able to challenge abnormal doses. Visit: www.nrls.npsa.nhs.uk
