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

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Existing In-patient Drug Administration Procedure (continued)Order verified correct bypharmacyDrugs prepared andsupplied by pharmacyYesNoIllegible/ambiguous/problematic drug ordersExisting Problems:• It is possible for an illegible/ambiguous orderto be misinterpreted or presumed to beanother drug.• Extra time or effort will be needed inconfirming the order.Drugs prepared & supplied by pharmacyThere are 2 methods of drug supply frompharmacy, which are Individual PatientDispensing and Ward Stock Supply. Wardstock are still needed due to the lack of a 24hours pharmacy service:Existing Problems:i) Individual Patient DispensingDispensing errors arise from :• Similar drug item codes• Similar drug names & sound-alikedrug names• Look-alike packages of drug items• Wrong dose calculation• Wrong information on labels• Non-compliance with the doublecheck systemii) Ward Stocks• Larger variety of ward stocks holding,pooling & transferring of ward stock andimproper rotation of ward stock may stillexist in those wards without the wardtopping-up system.• Prescriptions for ward stock items are notsent to pharmacy, thus the drug profiles ofpatients compiled by pharmacy areincomplete.• Pharmacy does not have the opportunityto verify these prescriptions and cannotmonitor the actual consumption of noncontrolledward stocks.• Nurses are not specifically trained todispense drugs.15
Existing In-patient Drug Administration Procedure (continued)Drugs delivered to the wardswithin the same hospital andof other hospitalsMost of the drugs are delivered to wards in properly locked receptacles except for the delivery bysatellite pharmacy where drugs dispensed are placed directly into the drug trolley in ward.Drugs delivered to the wards within the same hospital (except for Satellite Pharmacymodel )Existing Problems:• Physical constraints, e.g. insufficient locked receptacles for the transportation of drugs.• Locked receptacles are not absolutely safe and secure if plastic seals of no numberidentificationare used to lock the receptacles, tampering of seals is possible.Drugs delivered to the wards of the other hospitals (Cluster Pharmacy model)Some hospitals may provide in-patients drug dispensing service to other hospitals within the samecluster. The drugs will be dispensed against the MARs faxed from the receiving-hospital to thedispensing-hospital. The drugs will then be delivered to / picked up by the inter-hospital porterteam.Existing Problems:• Inadvertent dispensing for drugs prescribed outside the hospital formulary of the receivinghospitalis possible.• In the receiving-hospital, a larger variety and higher stock level may be required in wards andthe emergency drug cupboards for urgent requirement.• Longer duration of drug supply may be required as daily delivery service may not beavailable and this may increase the drug returns and drug wastage.• If more than one receiving-hospital is served, drugs may be placed in the wrong receptaclesand transported to the wrong hospitals resulting in treatment delay or medication incidents.16
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 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
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2.1 Concentrated potassium chloride
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Appendix 7Supply of Antidotes and D
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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
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7.4 Evaluation Record and report th
Page 94 and 95:
DISPOSAL OF HOSPITAL PHARMACEUTICAL
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Appendix 14Guidelines on the Handli
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Appendix 15Medication Incident <str
Page 100 and 101:
Hospital Authority Medication Incid
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QUALITY ASSURANCE IN DRUG THERAPYHO
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Fig. 1: ADR voluntary reporting sys
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PROCEUDRE FOR QUALITY COMPLAINTSONP
Page 108:
Part II Procurement Section, CPO1.
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