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

Electronic prescribing (Medication Order Entry -- MOE)4.27 Discharge and home leave prescriptions can be prescribed through the Medication OrderEntry (MOE) system. While electronic prescriptions improve legibility and remove theambiguity of orders, this should be developed in the in-patient section (In-patient MOE).Verbal Orders4.28 Only in emergency and approved circumstances may a verbal order be given if the doctor isunable to attend personally. The instruction may only be accepted by an Enrolled orRegistered nurse who must immediately record the instruction in the patient’s MAR andannotate it a ‘verbal order’.4.29 After the instruction has been written, it must be READ BACK to the doctor checking thepatient’s identity, drug name, dosage, frequency and method of administration. It is theresponsibility of the doctor giving the verbal order to ensure the correct interpretation of theverbal order.4.30 The nurse receiving the message must, after following the normal checking procedure,administer the drug and personally give both verbal and written instructions to the nursestaking over from him/her.4.31 A verbal order must be confirmed in writing by the doctor concerned as soon as possibleand within 24 hours at the latest [refer to Pharmacy & Poisons Regulations, Cap. 138A,Section 23(4)].4.32 Dangerous Drugs should not be ordered through verbal orders (refer to Dangerous DrugsRegulations, Cap. 134A, Section 3).Patient’s Own Medications4.33 Patients should always be asked if they have brought any medications into hospital withthem. To prevent unauthorised self-administration, brought-in medications should be takeninto safe custody by the nursing staff and shown to the doctor and/or pharmacist.4.34 The patient’s own medications should not normally be administered in hospital unless theyhave been positively identified, specifically prescribed by the doctor and when supplies arenot immediately available from hospital sources. The general practice of allowing patientsto continue their own brought-in medications without verification should not be encouraged.(Identification of medications currently used in the HA may be searched by the TabletIdentifier on HA intranet http://cpointra/tabident.php;Registered Pharmaceutical in Hong Kong may be searched on the website of Department ofHealth http://www.info.gov.hk/pharmser/Reg_ir/download_pharm.html)4.35 The protocol / logistics for identification, prescribing and administration of brought-inmedications to patients should be endorsed by the hospitals’ DTC.25