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URGENT INFORMATION.

A Rapid Response Report (RRR) is a one page alert from the NPSA providing an urgent warning to healthcare organisations of substantive risks which are new (or not well known) and could be prevented. Key information is provided in the RRR, focusing on harm and actions for healthcare organisations to reduce harm. More detailed evidence is provided in the supporting documentation to the RRR. This is designed to aid and assist local implementation. 
Further information can be gained by accessing the web links on the attachment..

Reducing risk of harm from oral bowel cleansing solutions
Death and harm from electrolyte abnormalities, dehydration and serious gastro-intestinal problems have been reported following the inappropriate use of oral bowel cleansing solutions (Picolax®, Citrafleet® , Fleet Phospho-Soda®, Klean Prep®, Moviprep®) prior to surgery and/or investigative procedures. Frail and debilitated elderly patients, children and those with contraindications are particularly at risk from these treatments.

Harm from these medicines result from lack of clarity in relation to who is:

• authorising the use of these medicines and is therefore clinically responsible for undertaking clinical checks and explaining their safe use to the patient and;
• authorised to supply these products and is responsible for providing written information about their safe use to the patient or healthcare staff administering these medicines. Currently the supply of these medicines may only involve non-clinical staff (e.g. administrative staff) with inadequate safeguards to ensure safe use.

The alert sets out action for all organisations in the NHS and independent sector where bowel cleansing solutions are used.

Deadline for action complete is 7 September 2009.
Julie Nightingale, Chair of GIRSIG
Director of Radiography
School of Health Care Professions
University of Salford
0161 2952158

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