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

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Drug Name4.11 There should be a hospital Formulary available. This Formulary should be regularly updatedand be easily accessed by medical & nursing staff. This Formulary should list the approvednames, i.e. the generic names and the dosage formulations of the drugs in stock. The habit ofusing trade names for drugs should be discouraged particularly when generics are beingdispensed.4.12 Prescriptions should be made in the most appropriate conventional form and dosage of drugs,as according to the hospital Formulary.4.13 All drugs should be prescribed by their approved name and should preferably be printed infull in BLOCK LETTERS. It is essential that all entries made on the MAR are complete andlegible. Only approved abbreviations should be accepted.4.14 A list of standard, HA-wide approved drug name and frequency abbreviations has beenestablished. Doctors should either prescribe in full text or adhere to this list ofabbreviations (refer to Appendix 3).4.15 A ‘Hospital Authority Drug Formulary’ has been drawn up. The professional staff can referto this list for cross reference and information.Dosage4.16 The dose of medications should be prescribed using the METRIC system. Also dosageshould be expressed in terms of the active ingredients and NOT, for example, the number oftablets or volume of liquid, except in the case of compound preparations.4.17 Dosage abbreviations and decimal points should be avoided. eg. 0.5g should be expressed as500 mg. To avoid any confusion with milligram (mg), Microgram should be written in fullinstead of mcg or μg. Units should be written in full instead of i.u.4.18 It is recommended that standardized dosing and dilution methods for a list of commonlyused IV medications should be devised and endorsed by the hospitals’ DTC. Doctors shouldprescribe the IV medications by their standardized dilution concentrations and choice ofdiluents in normal circumstances.Routes of Administration4.19 A list of unambiguous, standard abbreviations should be drawn up. Doctors should eitherprescribe in full text or adhere to this list of standard abbreviation in prescribing the route ofadministration (refer to Appendix 3). In case of doubt, the staff member who is responsiblefor the drug administration must verify with the prescriber the abbreviations used.Times of Administration4.20 Times of administration schedule should be clearly given. As an alternative, this can be preprintedon the MAR for regular medications. Doctors should need only to select theappropriate times on the chart. This will save the doctors’ time in stating the frequency of23
administration in full. If abbreviations are to be used, prescribers should adhere to the list ofstandard abbreviations of time for drug administration listed in Appendix 3. For drugadministering on a three times daily basis, ‘Schedule for the Administration of “tds” Drugs’in Appendix 4 may be referred to.4.21 For once ONLY medications, the date and time of administration should be specified. For‘as required’ medications, they should include the reasons for treatment, the maximumfrequency of administration and/or the times of administration if appropriate. For onceDAILY medications, it is recommended that the full text ‘daily’ should be used but NOT‘q.d.’ and the time of administration should also be specified.Valid Period4.22 When it is anticipated that a certain medication is to be given for a defined period, thisshould be clearly stated. Automatic ‘stop’ arrangements for a normal course of treatmentshould be agreed beforehand for certain groups of medication, e.g. antibiotics. Continueduse after such agreed period should then be subject to physician’s review.Signature4.23 The doctor must put their identification code or full name in block letters together with theirauthorised signature on all the prescriptions. The prescribing physicians’ most updatedspecimen signatures should be made available for reference by nursing and pharmacy stafffor checking purposes.Transcription of Drug Order4.24 A copy of the MAR in the doctor’s original handwriting should be sent to the pharmacy inorder to avoid transcribing errors. This can be done, for example, by using the NCR paper orby fax. In future this process would be replaced by a computerised order entry system.Alterations to a prescription4.25 No prescription item should be altered in part. Changes in a prescription order shouldinvolve the complete cancellation of the existing prescription item and the writing of a newone to avoid any ambiguity and consequent administration errors.Discontinuing and cancelling a prescription4.26 Prescriptions should be reviewed regularly by doctor. Medications should be cancelled ordiscontinued by drawing a diagonal line through the drug name and/or a slanted double-lineacross the administration section corresponding to the “discontinued” medication on theMAR in order to minimize the risk of continuous administration. Cancellations anddiscontinuations of instructions must be signed and dated.24
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 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
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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
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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