Delivering safer end of life care - ambulatory syringe drivers
Several pieces of work were commissioned regionally in 2009 to improve the quality, safety and experience of care that patients and their families received at the end of life. One of these pieces of work was related to ambulatory syringe drivers as concerns had been raised regarding the safe delivery of end of life care medications.
Dr Vincent Crosby coordinated an East Midlands wide audit and report which identified that all counties within the East Midlands still rely on MS16A (mm per hour) from Smith Medical (formerly from Graseby Medical) and MS26 (mm per 24 hours) from Smith Medical (formerly from Graseby Medical) syringe drivers to deliver end of life medications. However in December 2010, the National Patient Safety Agency, published a Rapid Response Report: Safer Ambulatory syringe drivers NPSA 2010/RRR019 alert, identifying the need to decommission these syringe drivers over the next five years.
There are currently two alternative options available for procurement in line with the European standard, firstly the Elgin Medical MP plus or the Mckinley T34. Both Nottinghamshire and Derbyshire have secured funding to remove the old form of syringe driver from service and replace them with the Mckinley T34 models. Lincolnshire, Leicestershire and Northamptonshire have also been recommended to purchase the same device so that there is consistency in the use of syringe drivers across the region. This will help reduce potential future risks resulting from the change-over to a new syringe driver in relation to staff awareness, education, training and competence given that many staff work across counties and service providers.
The Towards Excellence End of Life Care Workstream is coming to a close at the end of May 2011. However, the regional Towards Excellence Prescribing Workstream will be able to continue the support available to commissioners in overseeing and gaining assurance of the decommissioning and replacement of ambulatory syringe drivers. It will also take forward two further actions on the safe delivery of end of life medication:
