2005 Edition Report on Drug Administration Procedure & Practices ...

Hospital Authority Medication Incident <strong>Report</strong>ing Progamme (MIRP)8. With more than 1 1 / 2 years’ period of discussion since the idea was first recommended bythe Working Party on Drug Administration Procedure and Practices, and positivedevelopments in a number of HA Hospitals, it is time for an overall Medication Incident<strong>Report</strong>ing Programme (MIRP) to be set up for the Hospital Authority. The MIRP willcomprise the local <strong>Report</strong>ing Programme at each HA Institution and an overall monitoringand supporting function at the HAHO. Hospitals which already have a MIRP set up alongthe lines described below would continue to operate the programme whilst all otherHospitals are requested to set up their MIRP by 1 April 1994. The mode of operations ofthe MIRP are set out as follows:(a)(b)(c)(d)(e)(f)(g)(h)(i)Hospital staff are required to report all Medication Incidents (MI) irrespective ofwhether patients have been involved.Any staff coming to knowledge of a Medication Incident (MI) could report. Inparticular, managers responsible for operational units e.g. COS, DOM, WM, DM,should report.The reports are to be made on a standard proforma. A sample of such proforma isat Appendix I. Hospitals already with MIRP could retain their forms and otherhospitals could adapt the sample form at Appendix I for their own use.The identity of the staff involved in the Incident and the patient are NOTREQUIRED to be reported.The incidents reports are to be directed to the Hospital Drug Committee orequivalent mechanism. A panel consisting of at least one doctor, one pharmacistand one nurse will be appointed by the Hospital Drug Committee to review allreported cases in conjunction with the respective managers on a periodic basis.The Hospital Drug Committee will identify the underlying causes of each incidentand recommend appropriate preventive on remedial measures to the HCE.Hospital Drug Committee will also report the statistical data and anyrecommended action to the HAHO using the proforma at Appendix II.Documents related to these quality assurance activities are to be separately andsecurely filed by the Committee. This include the incidents reports which shouldNOT be filed into the patients medical record.These quality assurance related procedures should not interfere with any necessarycorrective and supportive therapy to the patient.Medication errors resulting in injury to the patient should be reported to theHAHO Legal Liaison Officer in parallel and handled separately according to HAGeneral Admin Circular No 2/92.Continuous Review and Follow-up action9. Whilst Hospitals will take appropriate remedial / preventive actions regarding problemsunveiled by reviewing medication incidents occurring locally, HAHO would monitor theoverall trend of medication incidents and consider appropriate global measures againstmajor or service wide problems and to support the Hospitals in this area.[Appendix I & II are not included] HAHO Feb 942