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

More documents

Recommendations

Info

QUALITY ASSURANCE IN DRUG THERAPYHOSPITAL AUTHORITY ADVERSE DRUG REACTION REPORTING PROGRAMMEPurpose1. This memo announces the setting up of the Hospital Authority’s Adverse DrugReaction Programme and its implementation.Background2. As unexpected or undesirable effect may arise during the course of drug therapy,appropriate quality assurance system for medication use should be in place to identifythe causation and prevent the occurrence of these events.3. Currently, central quality assurance programs regarding medication incidents andpharmaceutical product quality are in place at the Hospital Authority. The MedicationIncident <strong>Report</strong>ing Program (MIRP), initiated by the Drug Utilization ReviewCommittee (DURC), was set up to identify opportunities for quality improvement andto assist health professionals in reducing and avoiding medication errors. As for themonitoring of the quality of pharmaceutical products, there are central proceduralguidelines for the reporting and the handling of quality complaints set forth by theChief Pharmacist’s Office.Adverse Drug Reaction reporting4. It is well aware that adverse drug reaction (ADR) may cause unnecessary physicianvisits, hospital admissions, and increased length of hospital stay. Local study showedthat 4.4% of acute admissions to a general ward were due to adverse drug reactions.To reduce these unnecessary admissions or hospitalization, it is thus important toidentify those ADRs which may be avoidable.5. Many overseas countries have a national ADR reporting system in place, whichcollects ADR reports from health care professionals for the purpose of assessing thesafety of the marketed drugs. Although the reporting of ADR is voluntary, manyhospitals have set up internal reporting programs to further improve the quality of carein their institutions. The ADR reports collected in the hospitals are forwarded to theirrespective agency for central review.6. Currently there is no systematic ADR reporting program in HA. A few hospitals arecollecting their own ADR reports without any inter-hospital communications orsharing of the reports. In order to unify the ADR reporting systems and to encouragemore active reporting throughout the HA, a centralized reporting system is considereddesirable.7. The potential problem of setting up a separate ADR reporting program in parallel tothe existing MIRP had been thoroughly considered and a pilot exercise had beenconducted in OLMH and QMH from October 2000 to March 2001. Taking referencefrom the pilot exercise and overseas experience it is now proposed that the HA ADRreporting program would be set up as from 1 January 2002.1
Hospital Authority Adverse Drug Reaction (ADR) <strong>Report</strong>ing Programme8. The ADRs would be reported via a similar mechanism (See Fig.1) as the medicationincidents and the mode of operation are set out as follows :a) A local reporting program set up at each HA institution.b) Suspected ADRs will be reported on a standard form, filled by a doctor or apharmacist. A sample of the form is attached in Appendix I.c) The reports are directed to the ADR sub-committee of the hospital’s Drug &Therapeutic Committee -• Each ADR report is evaluated and given a causality rating.• Educational feedback will be provided to the prescribers and otherhealth care professionals.• The completed ADR reports are to be forwarded to the CPO on aquarterly basis.d) The CPO would analyse the overall trend of the ADRs and take appropriatemeasures to enhance safety in medications.9. As recommended in the 2000 <strong>Edition</strong> of the “<strong>Report</strong> on Drug AdministrationProcedures and Practices”, a standard reporting mechanism/format should beestablished to collect information on ADRs from the hospitals for analysis on a regularbasis. Doctors, pharmacists and nurses should be alert to the potential occurrence ofADR.[Appendix I is not included] HAHO Oct 012
Page 2 and 3:
ForewordMedication safety and provi
Page 4 and 5:
Chapter 6 summarizes the specific r
Page 6 and 7:
Chapter 6Conclusions and Recommenda
Page 8 and 9:
CHAPTER ONETHE WORKING GROUPMEMBERS
Page 10 and 11:
CHAPTER TWOTHE PROGRESS REPORT2.1 P
Page 12 and 13:
CHAPTER THREEAREAS FOR IMPROVEMENT
Page 14 and 15:
Existing In-patient Drug Administra
Page 16 and 17:
Page 18 and 19:
Page 20 and 21:
Page 22 and 23:
CHAPTER FOURRECOMMENDED PRACTICES A
Page 24 and 25:
Drug Name4.11 There should be a hos
Page 26 and 27:
Electronic prescribing (Medication
Page 28 and 29:
4.46 When the use of CM is permitte
Page 30 and 31:
cytotoxic and central intravenous a
Page 32 and 33:
4.72 Special precautions should be
Page 34 and 35:
4.84 To prevent mixing up medicatio
Page 36 and 37:
The Principle of Three checks and F
Page 38 and 39:
4.111 Three-way (red and blue) and
Page 40 and 41:
or their discharge or death, should
Page 42 and 43:
operational requirement but also it
Page 44 and 45:
Quality Complaints on Pharmaceutica
Page 46 and 47:
LEVELSHAHOCE / DTOOLS & MECHANISMDU
Page 48 and 49:
Medication Incident Report<
Page 50 and 51:
Continuing Education6.18 In order t
Page 52 and 53: APPENDICESAppendix 1Appendix 2Appen
Page 54 and 55: Hospital Authority Hospital No. : I
Page 56 and 57: Sensitivity:Prescription/ routewith
Page 58 and 59: Appendix 3aLists of HA-wide Approve
Page 60 and 61: DRUGTeniposideABBREVIATIONVM-26Thia
Page 62 and 63: Appendix 3b“Do Not Use Abbreviati
Page 64 and 65: Appendix 4Schedule for the Administ
Page 66 and 67: Appendix 5Mechanism for the Managem
Page 68 and 69: 4. As with all medications, there s
Page 70 and 71: Appendix 6HA Guideline on Safe Mana
Page 72 and 73: 2.1 Concentrated potassium chloride
Page 74 and 75: Appendix 7Supply of Antidotes and D
Page 76 and 77: 複本 Antidotes and emeg drug lis
Page 78 and 79: Appendix 8Guidelines for Supply of
Page 80 and 81: substitution with other drugs in ac
Page 82 and 83: Appendix 9Samples of the Line Label
Page 84 and 85: Appendix 10Guidelines on the use of
Page 86 and 87: Appendix 11Guidelines on Patient Se
Page 88 and 89: Operational Guidelines7. The operat
Page 90 and 91: COC(N) Paper 12/2004Approved by COC
Page 92 and 93: 7.4 Evaluation Record and report th
Page 94 and 95: DISPOSAL OF HOSPITAL PHARMACEUTICAL
Page 96 and 97: Appendix 14Guidelines on the Handli
Page 98 and 99: Appendix 15Medication Incident <str
Page 100 and 101: Hospital Authority Medication Incid
Page 104 and 105: Fig. 1: ADR voluntary reporting sys
Page 106 and 107: PROCEUDRE FOR QUALITY COMPLAINTSONP
Page 108: Part II Procurement Section, CPO1.
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?