Resources, guidance and support to assess and improve medication safety culture, strategy and policy within the healthcare system


A forum for individuals to discuss challenges and successes to inform and inspire medication safety initiatives across the system.

Medication safety across the system: time critical medicines

11 May 2023Discussion of key current medication safety challenges within healthcare with a focus on time critical medicines; inspiring partnership across the system.
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Medication Safety Updates

A summary of recent practice communications reports, publications and safe medication practice research, including emerging issues pertinent to medication safety.

Medication Safety Update

23 February 2023A resource collating the latest medication safety communications and publications to inform, support and inspire medication safety improvements.
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Support and guidance for MSOs

Medication Safety Officers promote and ensure safe medication practice. Our resources provide practical support, guidance and tips for MSOs and those working alongside or managing MSOs as well as any individual responsible for the safe use of medicines.

The Medication Safety Officer (MSO) role

15 December 2022Understanding the role and responsibilities of the MSO in practice will assist organisations in delivering their medication safety agenda

Practice support for the Medication Safety Officer (MSO)

15 December 2022An infrastructure of support opportunities exists that MSOs should utilise to deliver their role most effectively

Collaboration opportunities to improve medication safety

15 December 2022Practical guidance on effective collaboration opportunities to promote medication safety improvements

Reporting and management of medication incidents and harms

15 December 2022High quality reporting and management of incidents and harms ensures opportunities for learning and improving medication safety

Promoting medication incident reporting

15 December 2022Increased medication incident reporting provides greater opportunities for learning and improving medication safety

Learning from medication incidents and harms

15 December 2022Practical guidance to ensure opportunities to learn from local intelligence, including patient harm are translated into shared local and national learning

Resources to support learning from medication incidents and harms

15 December 2022Organisations should utilise resources to effectively drive improvement based on the learning from incidents, concerns, disputes and claims

Conducting a medication incident investigation

15 December 2022Practical guidance to support those undertaking medication incident investigations

Communication opportunities to improve medication safety

15 December 2022Effective communication allows for timely responses to new and emerging medication risks and the sharing of potential safety solutions.

Using the Medication Safety Update effectively

15 December 2022Effective use provides assurance that an organisation is aware of the most critical medication safety related information, and acts on this to improve safety

Responding to medication safety alerts and notifications

15 December 2022Healthcare professionals responsible for medication safety in their organisation must deliver an appropriate response to safety alerts

Understanding medication safety policy and frameworks

15 December 2022Healthcare professionals delivering the medication safety agenda in their organisation require an understanding of national policy, frameworks and legislation

Managing the risks of specific medicines

Identifying known risks associated with specific medications and mitigation strategies to prevent harm

Reversing an adult opioid overdose with naloxone in the medical setting

18 October 2022A patient safety alert highlighted the risks of giving inappropriate doses of naloxone. This page guides on using appropriate intravenous doses.

Using intravenous paracetamol preparations safely in paediatrics

21 September 2022Safety risks and mitigation strategies are described to reduce the risk of errors with intravenous paracetamol in neonates, infants, and children.

Safety considerations when using Vitamin D

7 September 2022Healthcare professionals who use vitamin D should be aware of the risks of toxicity and safe practice principles which may prevent patient harm

Metolazone preparation differences and safety considerations

7 September 2022Healthcare professionals involved in the use of metolazone need to be aware of the differences between licensed and unlicensed products to ensure safe care.

Using potassium permanganate for skin conditions or wound care

15 November 2021Potassium permanganate is a chemical product. We review the evidence for using it in wound care and highlight the risk of severe harm associated with wrong use.

Understanding safety risks with betamethasone soluble tablets used as mouthwash

9 July 2021Serious side effects can be caused if betamethasone soluble tablets used as mouthwash are swallowed. Providing clear patient directions can help prevent harm

Quality Improvement Alert - Cold Chain Management of COVID-19 Vaccines

19 May 2021An SPS quality improvement alert to highlight the requirements for safe and effective cold storage of COVID-19 vaccines

Good governance guidance when handling multiple COVID-19 vaccines

2 March 2021Practice points to ensure good governance when planning or designing vaccination services where multiple vaccines are used.

Safe practice for handling multiple COVID-19 vaccines

2 March 2021A number of COVID-19 vaccines are available, all with different handling and dosing requirements; sites need to plan to reduce the risk of errors
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