Home and Community Care Personal Support Worker Organizations Medication Safety Self-Assessment Introduction

The Home and Community Care Personal Support Worker Organizations Medication Safety Self-Assessment® was developed by the Institute for Safe Medication Practices Canada (ISMP Canada) to:

  • Heighten awareness of the distinguishing characteristics the create a safe medication system when caring for clients in the home;
  • Create a baseline measure to monitor strategies put in place to improve safety of medication use in the home; and to
  • Assist personal support worker organizations to evaluate their efforts over time, thereby acting as a quality improvement tool.
The self-assessment is divided into ten sections - referred to as 'core characteristics' in the graph results - that most significantly influence safe medication use.

What are the benefits of completing this MSSA?

Medication incidents in the home can occur in all stages of the medication handling system. There can be errors with prescribing and assessing, transcription, dispensing, delivery, storage, repackaging, administration or assisting (both from health care providers as well as patient/family), monitoring and disposal of medications.

Recent data from the Institute of Health Policy, Management and Evaluation quantified the cost burden of ADEs in Ontario to be $13.6 million1 annually. A report from CIHI indicates that polypharmacy increases a senior's risk of an adverse drug reaction related hospitalization.2 Another recent home care study validated that polypharmacy is a risk factor for ADVERSE DRUG EVENTS in the home. Contributing factors such as communication failures, lack of team integration, inconsistency in home care planning and delivery as well as inconsistent medication packaging, processes and equipment were identified.3 The MSSA encompasses all of the above contributing factors.

Care delivered in the home is predominantly provided by family and caregivers, or unregulated health care workers . Challenges exist on how to manage medications safely and enable early detection of risk intervention when regulated health professionals are minimally involved. Personal support workers are front-line direct care providers. They may be the first to identify MEDICATION RISK situations and require the appropriate knowledge and processes to ultimately reduce medication harm.

This MSSA was developed for organizations who deliver direct-care personal support worker services in the home and community. It will increase awareness of the potential for MEDICATION INCIDENTs and risk, thus challenging organizations to review existing medication related policies and procedures and to develop new processes with the goal of reducing medication harm to clients.

Security and Protection of Self-Assessment Information Submitted to ISMP Canada

All information submitted to ISMP Canada is maintained in a secure database maintained solely by ISMP Canada. The application does not allow viewing of data or demographic information associated with individual assessment information. All information is contextually de-identified, and the demographics and submitted results will be used only for aggregate data reports. Usernames are assigned by ISMP Canada and passwords required for submitting information are self-selected by the organization participating in the self-assessment. Access to any contact information voluntarily provided by the organization (i.e., email address for lost or misplaced password only) is restricted to a small number of ISMP Canada personnel and confidentiality is assured.

ISMP Canada is not a standard-setting organization. As such, the self-assessment items in this document are not purported to represent a minimum standard of practice and should not be considered as such. In fact, some of the self-assessment items represent innovative practices and system enhancements that are not widely implemented in home care today. However, their value in reducing errors is grounded in research and expert analysis of medication errors and their causes.

Please contact mssa@ismp-canada.org for more information.

1 Wu C, Bell CM, Wodchis WP. Incidence and economic burden of adverse drug reactions among elderly patients in Ontario emergency departments: a retrospective study. Drug Saf. 2012 Sep 1;35(9):769-81

2Canadian Institute for Health Information. Adverse Drug Reaction-Related Hospitalizations Among Seniors, 2006-2011. March 26, 2013. Accessed March 19, 2014. http://www.cihi.ca/CIHI-ext-portal/internet/en/Document/types+of+care/pharmaceutical/RELEASE_26MAR13

3Doran, D. Blais, R. et al. Safety at Home: A Pan-Canadian Home Care Safety Study. 2013 CPSI publication. Accessed Jan 18, 2014.