What are Adverse Drug Reactions?
Adverse drug reactions (ADRs) range from severe, life-threatening anaphylaxis to mild, typical side effects (Montane & Santesmases 2020). ADRs are unintended and harmful incidents resulting from administering a particular medicine (Therapeutic Good Administration 2021). ADRs can present in many ways, such as allergic reactions, side effects, or interactions with other medications. They can be classified into two main categories:
- Type A: Augmented reactions, which are dose-dependent and predictable.
- Type B: Bizarre reactions, which are dose-independent and unpredictable.
The risk factors contributing to ADRs may include the patient's age, polypharmacy, and comorbid conditions (Johnson & Dunn 2017).
What is the "Adverse Drug Reactions" Training Requirement?
Training your staff to care for a person taking medication is critical. This training should include the identification, prevention, and management of ADRs and should be ongoing to keep healthcare professionals up-to-date with the latest practices and guidelines.
Relevant Standards
Action 4.07: Collecting adverse drug reaction history:
The healthcare organisation has a patient documentation process to collect a patient's history of medication allergies, including a record of prior adverse drug reactions.
Action 4.08: Adverse drug reaction documentation processes:
Processes for documenting adverse drug reactions that patients experience under the provision of care in the healthcare record are in place and included in organisation incident reporting systems.
Action 4.09: Therapeutic Goods Administration reporting:
Processes are in place to report adverse drug reactions to the Therapeutic Goods Administration (in accordance with its requirements)
National Safety and Quality Health Service (NSQHS) Standards
Requirement 3.3 (b): High-impact or high-prevalence risks:
Effective management of high-impact or high-prevalence risks associated with the care of each consumer
The provider documents existing or known allergies or side effects to medicines, vaccines or other substances at the commencement of care and monitors and updates documentation when new allergies or side effects occur.
The provider implements processes to identify, monitor and mitigate risks to older people associated with the use of high-risk medicines, including reducing the inappropriate use of psychotropic medicines.
The provider has processes to report adverse medicine and vaccine events to the Therapeutic Goods Administration.
Final Draft- The Strengthened Aged Care Quality Standards- Aged Care Quality Standards
Related Training Requirements Guides
The following Training Requirement guides can be used to support and facilitate the adverse drug reactions training requirement:
Skills Required by Staff for Adverse Drug Reaction Prevention and Management
Equipping staff with the right skills is critical to minimise the impact of ADRs. Below are various skills required to remain safe and vigilant:
| Skill | Key Elements |
|---|---|
| Identification | Staff should be skilled in recognising the early signs and symptoms of ADRs. This includes changes in vital signs, patient complaints, and unusual laboratory findings. |
| Prevention | Healthcare staff must have in-depth knowledge of medication administration practices, including dosage calculations, timing, and routes of administration. |
| Management | Skills in recognising deterioration are essential. This involves activating emergency protocols and administering antidotes or other necessary treatments. |
| Communication | Staff must communicate clearly and respectfully with team members to ensure comprehensive care is provided. |
| Documentation | Documenting all medication administered and witnessed ADRs is vital for patient safety and legal compliance. |
How to Assess Staff Competency on Adverse Drug Reactions
Practical assessment of staff competency may include the following:
- Written assessment: To assess theoretical understanding.
- Practical demonstrations: To validate skills in medication administration and ADR identification.
- Competency assessment: Ongoing competency assessment during practical sessions can offer valuable insights into a staff member's abilities and thought processes.
- Peer reviews: Colleagues can offer valuable perspectives on a staff member's competencies.
By regularly assessing staff competence, you can identify areas for improvement and tailor training accordingly.
Strategies to Support Healthcare Staff Reinforce Adverse Drug Reaction Knowledge
Education and training should not end after an initial training; it should be a continuous process. Training for ADR prevention and management can be performed (and not limited to) in the following ways:
- Mentorship: Experienced staff can provide hands-on training and guidance for learners.
- Simulation training: Simulated environments allow staff to hone their skills without endangering patients.
- Workshops: These should cover topics such as the definitions and classification of adverse drug reactions (ADRs) to provide a solid understanding. They should also focus on the epidemiology and population impact of ADRs and identify common reactions that healthcare professionals may encounter
- Feedback: Regular performance evaluations help identify areas for improvement and celebrate areas of success.
(Ar Kar Aung 2022)
Sample Training Plan for the Adverse Drug Reactions Training Requirement
An effective training program can reinforce the staff's ability to manage and prevent ADRs by identifying knowledge gaps.
Using the above needs assessment survey as an example - The adverse drug reaction skills that require the most attention are identification and management skills. We can target learning initiatives to fill these gaps to enhance staff competency.
Need an LMS that can support adverse drug reaction training?
Contact Ausmed today and see how we can support with your adverse drug reactions training requirements!
Staff Competency Assessment for Adverse Drug Reactions - Example
To assess your healthcare staff competence in Adverse Drug Reactions, consider asking these survey questions:
Staff Survey - Adverse Drug Reactions Competency
-
Can you list three common signs of an adverse drug reaction?
- [Sign 1]
- [Sign 2]
- [Sign 3]
-
How would you respond to a suspected ADR?
- [Answer here]
-
Describe an escalation process when you have identified patient deterioration.
- [Answer here]
-
What ADR reporting tools do you have in your workplace?
- [Answer here]
Conclusion
Addressing the significant issue of ADRs in Australia requires a comprehensive, multi-faceted training program. Ensuring that healthcare professionals are adequately trained and continually assessed can substantially mitigate the risks and improve patient outcomes.
References
- Australian Commission on Safety and Quality in Health, 2023, Medication Safety Standard, Australian Government, viewed 12 October 2024, https://www.safetyandquality.gov.au/standards/nsqhs-standards/medication-safety-standard.
- Australian Commission on Safety and Quality in Health, 2023, Action 4.07, Australian Government, viewed 12 October 2024, https://www.safetyandquality.gov.au/standards/nsqhs-standards/medication-safety-standard/documentation-patient-information/action-407.
- Australian Commission on Safety and Quality in Health, 2023, Action 4.08, Australian Government, viewed 12 October 2024, https://www.safetyandquality.gov.au/standards/nsqhs-standards/medication-safety-standard/documentation-patient-information/action-408.
- Australian Commission on Safety and Quality in Health, 2023, Action 4.09, Australian Government, viewed 12 October 2024, https://www.safetyandquality.gov.au/standards/nsqhs-standards/medication-safety-standard/documentation-patient-information/action-409.
- Aung, A.K., Walker, S., Khu, Y.L., Tang, M.J., Lee, J.I. & Graudins, L.V., 2022, Adverse drug reaction management in hospital settings: review on practice variations, quality indicators and education focus, European Journal of Clinical Pharmacology, 78(5), pp. 781-791.
- Aged Care Quality and Safety Commission, 2023. Aged Care Quality Standards, ' Standard 3. Personal care and clinical care - Requirement 3.3.(b)'
- Aung, A.K., Walker, S., Khu, Y.L., Tang, M.J., Lee, J.I. & Graudins, L.V., 2022, 'Adverse drug reaction management in hospital settings: review on practice variations, quality indicators and education focus', European Journal of Clinical Pharmacology, 78(5), pp. 781-791.
- Department of Health and Aged Care, 2023, The Strengthened Aged Care Quality Standards - Final draft, Australian Government, viewed 12 October 2024, https://www.health.gov.au/resources/publications/the-strengthened-aged-care-quality-standards-final-draft?language=en.
- Department of Health and Aged Care Therapeutic Goods Administration 2021, ‘Reporting adverse events’, Australian Government, https://www.tga.gov.au/resources/resource/reference-material/reporting-adverse-events.
- Iasella, C.J., Johnson, H.J. & Dunn, M.A., 2017, 'Adverse drug reactions: Type A (intrinsic) or Type B (idiosyncratic)', Clinics in Liver Disease, 21(1), pp. 73-87.
- Montané, E. & Santesmases, J., 2020, 'Adverse drug reactions', Medicina Clínica (English Edition), 154(5), pp. 178-184.
