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‘To lock up or not to lock up?’- A survey of the storage of obstetric anaesthetic drugs in London tertiary hospitals, UK.
Abstract Number: T1H-456
Abstract Type: Original Research
In the UK there is currently no specific advice on the storage of non controlled drugs in anaesthetic rooms, as opposed to clear guidance on the storage of controlled drugs. In the field of obstetric anaesthesia 83% of surveyed UK anaesthetists never use this room for anaesthesia, going directly to theatre for induction(1). The anaesthetic room often remains the place of storage and preparation for our anaesthetic drugs. The UK Care Quality Commission (CQC), requires that non-controlled drugs not in use remain locked up, which seems at odds with national guidance suggesting non-controlled drugs cupboards may remain unlocked in defined circumstances(2). It is a serious patient safety concern if drugs cannot be easily obtained in very time critical obstetric emergencies.
The ASA have recognised that procedures designed to prevent unauthorized access to non-controlled drugs must not impede the imperative for patient safety. The Royal Pharmaceutical Society recommends there should be a standard of practice (SOP) covering drug storage that will put patient safety first but will ensure the safety and security of medicines we store and use.
Clinical leads for obstetric anaesthesia in 16 London hospitals were invited to complete an email questionnaire. Questions examined the preparation, storage and access of common emergency obstetric anaesthetic drugs, the existence of SOPs in each local department and any adverse patient critical incidents due to inaccessible drugs.
Responses from 11 London hospitals (69% response rate). Only 2 (18%) of the hospitals surveyed had SOPs for safe storage and there was one account where lack of immediate access contributed to a critical incident of laryngospasm. Four of the hospitals had improved security of drugs as a direct consequence of CQC inspection.
A uniform practice has not been adopted in our region. There is a need for a consistent SOP that uses a risk management approach, which will minimise accidental or unauthorised intentional access whilst balancing the need for urgent immediate access in obstetric emergencies. Hospitals with the most consistent security policy across non-controlled anaesthetic drug modalities have done so with either fridge key-codes or zoned security for each theatre.
1. Int J Obstet Anesth. 2005;14(1):14-21.
2. Rcoa.ac.uk. https://www.rcoa.ac.uk/document-store/storage-of-drugs-anaesthetic-rooms-guidance-best-practice-the-rcoa-and-aagbi