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

cytotoxic and central intravenous admixture services by pharmacy would improve qualityand safety. In addition, a number of issues have been considered :(a)(b)(c)Limiting the choices of available drugs in pharmacy and the dose concentration orstrength for each drug would help to reduce the chances of errors.Complete, updated information on the reconstitution, dilution and compatibility ofintravenous drugs should be supplied by pharmacy to the nurses on the wards foreducational and cross-checking purposes. 1Doctors who have prescribed unconventional strengths or forms of a drug should becontacted by a pharmacist in order to discuss for modifying the prescription.Accuracy in Dispensing4.59 Proper in-house checking procedures should be built into the dispensing system in thepharmacy. The pharmacy staff must remain alert in the process of data entry, as similar drugcodes often give rise to medication errors. It is important to recognise that the merechecking of the label against the content is not sufficient. Reference should always be madeto the ORIGINAL prescription in checking the end product of the dispensing process for thecorrectness of the drugs and any possible undesirable interactions amongst them. The doublecheck system should be practised whenever possible.4.60 For high risk drug items e.g. digoxin, or those known to be associated with seriousmedication errors, all steps in the dispensing process especially the calculation of dose,should be checked independently by another member of the pharmacy staff, preferably apharmacist.4.61 Every prescription order and all dispensed medications should preferably be checked by apharmacist, for detecting and dealing with any potential medication errors and potentialproblems such as contraindicated drug, drug interactions. Any necessary clarification in aprescription order must be resolved with a doctor before the medication is dispensed andadministered to the patient.Labelling of Dispensed Medications4.62 The labelling of dispensed medications allows for the positive identification of the drug andthe patient to whom the drug is supplied. Proper labelling should be provided on alldispensed medications in compliance with the requirements of the Hong Kong MedicalCouncil and the Pharmacy and Poisons Board. The list of requirements for the labelling ofmedications is as follows :(a) Name of patient(b) Date of dispensing(c) Trade name or pharmacological name of the drug 2(d) Dosage per unit1 Cross-checking is defined as checking the correctness of the information or a calculation by a different personwhile double-checking is defined as checking the correctness twice by the same person or by a different person.2 In HA, this will be in the form of approved pharmacological name or when unavoidable, trade name of the medication(i.e. in the case of compound preparation). Exemption might be made for approved research when patients have giventheir fully informed consent, the drug name might not be included.29