The stock of medicine at Mount Carmel Hospital wards was not being monitored, the Auditor General found, flagging the risk that drugs might not be “properly secured and dispensed”.
The National Audit Office’s report on the public accounts for 2017 said “control weaknesses” were encountered during inspections, particularly within the mental hospital’s wards.
“This also included the lack of traceability of medicines up to patient dispensing level. Other major concerns were the inadequate security measures for stores and the absence of continuous back-up provision in case of power failure in pharmacy stores,” it noted.
According to NAO officials who carried out random inspections at five wards, while a stock register for drugs labelled as “dangerous” was kept, there was no such information for other medicine.
Despite a register for such drugs being kept, the NAO inspectors found discrepancies in the stock of such medicine, with tablets found to have gone missing in two of three randomly-selected wards.
“Stock control in hospital wards is to be improved to ascertain adequate supply and usage as well as prevention of expiration of products,” the NAO recommended.
In a reply to the report, the hospital said stock management in wards was being “consolidated” and that a system was being rolled out whereby demands from wards were made on a “named patient basis”.
“Moreover, a ward top-up service is in place for a number of wards. This service will be rolled out when further technical manpower is made available,” the management said.
The Auditor General highlighted inadequate security measures for stores after it found that all three were not equipped with security alarms or cameras to mitigate the risk of theft or abuse.
“Access to the pharmacy and the stores holding surgical materials was still rudimentary by the traditional lock and key. This results in security risks, in view that keys can be copied, stolen or lost. Furthermore, such system does not track entry and exit, thus maintaining access log in the event of a security breach or emergency,” the report said.
The management said it would be “exploring other options” aimed at improving such shortcoming.
The NAO found that about €2,166 worth of expired medicine was still being kept in the wards’ treatment rooms until a notice of disposal was received from the pharmacy.
“Ideally, non-usable and expired medication is stored in a separate and secure location, under the control of the pharmacy, until its disposal,” the Audit Office report said.