A dose of good medicine


Weights and measures In this feature treatment non-compliance case studies A dose of good medicine Accurate weighing equipment in medical facilities is crucial for the health and wellbeing of patients. Christine Munteanu explains why, and reveals the results of the latest National Measurement and Regulation Office report into compliance S ince 1 January 2003, weighing equipment used in the practice of medicine across the European Economic Area and Switzerland has been prescribed under the Non-automatic Weighing Instruments Directive. This legally controlled the weighing of patients and of prescription medicines for the rst time in the UK and was a key step towards ensuring accurate measurements in medicine. Measurements are often fundamental to medical treatments or interventions; for example, weight is frequently used to determine treatment and dosage, and can be critical when determining such things as chemotherapy doses for small children and babies. Accurate information about weight gain/loss in infants and the elderly is also vital for deciding which treatment or medical interventions may be necessary. If measurements are wrong, things could be missed or unnecessary interventions made. The National Measurement and Regulation Ofce (NMRO) has been working with local weights and measures authorities (LWMAs) to deliver a national legal metrology project. This will assess equipment used by pharmacies, doctors surgeries, health centres and mobile health visitors, to improve accuracy. An earlier project was carried out between 2008 and 2009 by the Local Authorities Coordinators of Regulatory Services (LACoRS) and NMRO, which was then the National Weights and Measures Laboratory. This project looked at hospitals weighing equipment, with a view to assisting and promoting good practice. The reported non-compliance rates were 34 per cent in 2008 and 19 per cent in 2009. Demonstrable improvements were reported over the course of the project, particularly in relation to buying suitable equipment and using it properly. Two case studies revealed examples of inadequately trained staff and inadequate test methods for the calibration of instruments Feedback from the Trading Standards Metrology Expert Panel and the annual returns from LWMAs indicated that this was an important area for local authorities, which had taken on responsibility for public health. A national project was recommended as an effective method of raising awareness and improving compliance. In light of this, NMRO coordinated its National Legal Metrology Project on Medical Weighing from 2014 to 2015, focusing on equipment used by pharmacies, doctors surgeries, health centres and mobile health visitors. LWMAs from each region of the UK were represented and 27 per cent of all LWMAs participated in the project. The methodology was to send a letter to suitable premises, explaining the remit of the project, and to follow this up with a visit to inspect the weighing equipment, checking it for accuracy and suitability. Advice was issued to staff on the appropriate use of weighing equipment. Where extensive problems were found in a particular area, advice was offered to both inspected and uninspected premises. The overall results of the project showed a 23 per cent noncompliance rate. This was disappointingly high, especially as 23 per cent of the equipment was also found to be unsuitable for the medical purpose for which it had been bought. Examples of unsuitability were weighing equipment with a scale interval that was incorrect for its intended use, and the use of bathroom scales that were not approved. In some circumstances, the use of such equipment could have led to errors in diagnosis or treatment. Two case studies included in the project report revealed evidence of inadequately trained staff and inadequate test methods for the calibration of instruments. There were examples of in-house testing being carried out by untrained staff, and no testing of the instruments at maximum capacity, which led to signicant errors at the upper end of the instruments capacity. One of the main problems identied was a lack of knowledge among those using the equipment about the legal and technical requirements that are there to ensure accurate measurement. The project has gone some way to addressing this, with inspectors of weights and measures helping to bring visited premises into compliance, and by raising awareness. The NMRO is also working with manufacturers of medical weighing equipment, those offering calibration services, the NHS supply chain and trading standards to increase knowledge in this area, and to raise standards further. The NMRO will add medical weighing equipment as a separate category to the risk matrix issued annually to LWMAs, to help them assess how to deploy their resources. The equipment will be rated as very likely to fail with a high risk of impact. Credits Published Christine Munteanu is assistant director Tuesday 25 August, 2015 of the regulation team at the National Measurement and Regulation Ofce. Images: bikeriderlondon / Shutterstock To share this page, click on in the toolbar