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

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Existing In-patient Drug Administration Procedure (continued)Nurse records drugadministration in the wardThe monitoring & reporting ofthe patients’ responses tomedicationsNurse records drugs administration in thewardUnder the existing practices, there are twogroups of patients regarding medicationadministration.The first group of patients participate in theself-administration programme, and can selfadministertheir own drugs. The other group ofpatients will take their medications under thesupervision of the nursing staff.Existing Problems:• For the second group of patients, nursesmay not wait to confirm that the medicationhas been consumed by the patient in somebusy wards. Unattended drugs left on apatient’s over-bed table may lead to theomission of doses or drugs being consumedby the wrong patient.• The medications for a particular patientmay be charted in more than one place andmultiple records can potentially lead toconfusion and errors.• Nurses may not be aware of thediscontinued medications on the MAR andmay continue to administer to patients.• Medications may not be administeredaccording to the recommended time /intervals of administration.The monitoring & reporting of patients’responses to medicationsAdverse Drug Reaction (ADR) <strong>Report</strong>ingThere is a standard procedure or mechanism torecord clinically significant ADR in HAhospitals.Existing Problems:• Some ADR may not be reported.Medication Incident (MI) <strong>Report</strong>ingThere is a standard procedure or mechanism toreport MI in HA hospitals. <strong>Report</strong>ing of MI byelectronic means via the AIRS will be rolledout in phrases to more hospitals of the HA.Existing Problems:• Some medication incidents such as nearmisscases may not be reported.• Those medication errors which have beenrectified before drug administration areunder reported in some hospitals. These‘near-miss’ cases can actually be used foreducational purposes.• Insufficient follow-up action & educationfollowing medication incidents.19
Existing In-patient Drug Administration Procedure (continued)Nurse disposes or returns warddrugs to pharmacyNurse disposes or returns ward drugs topharmacySome dispensed drugs are unused due to thedischarge or death of patients or other reasons forthe discontinuation of treatment. These left-overneeded to be returned to pharmacy or disposed ofin other ways.Existing Problems:• Over-prescribing, frequent changes in drugtherapies and inefficient drug distributionsystems have all contributed to the hugeamounts of ward drugs returned for disposal.This has created much unnecessary and costlydrug wastage.• A lot of manpower and time are used insorting out the returned drugs.• Unused drugs might be pooled together inwards to form ‘unofficial’ ward stocks.• Refrigerated drugs are left in roomtemperature for a certain period of time priorto returning to pharmacy render the drugsinappropriate for reuse.20
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
Page 72 and 73:
2.1 Concentrated potassium chloride
Page 74 and 75:
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
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
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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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