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

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4.84 To prevent mixing up medications for different patients, it is essential that drug trolleys withseparate receptacles for keeping the individual patients’ medications should be used on thewards.4.85 Ward drug cupboards and drug trolleys have to be kept locked when not in use and to bekept out of reach of patients.4.86 DD should be kept under lock and key in a designated drug cabinet and the key should bekept by the nurse in-charge at all times.4.87 Some medicinal products require storage at a low temperature. Pharmacy and ward staffshould check the labelling on the product for the appropriate storage requirements.Pharmaceutical refrigerators, wherever possible, should be used for the proper storage ofdrugs in wards and in pharmacy. It should be equipped with a maximum/minimumthermometer. The temperature should be checked regularly and should be in the range of2°C to 8°C. The refrigerators used for storing medications, should be used solely for thispurpose4.88 It is important that medicinal products for external use be stored separately from the drugitems that are for internal use. Medicinal products for external use e.g. liquid antiseptics,have to be stored in a SAFE place and labelled with the warning “For external use only”.Inspection of Storage and Records of Drugs4.89 The designated registered pharmacist(s) or medical practitioner(s) should inspect the storageconditions of poisons in places, such as pharmacies and wards, where poisons are requiredto be stored at regular intervals of time not exceeding three months in accordance with therequirements as stipulated in the Pharmacy & Poisons Regulations, Cap. 138A, Section24(5).4.90 The person(s) appointed by the medical officer in charge of the hospitals / clinics shouldexamine the storage, supplies and stocks of the DD in the hospitals / clinics at least once inevery month in accordance with the requirements as stipulated in the Dangerous DrugsOrdinance, Cap. 134, Section 23(5).Storage of Dangerous Goods (DG)4.91 Dangerous Goods (DG) should be stored at designated places in the clearly labelledchemical storage cabinets. Only minimum amount should be kept at the place of workaccording to OSH recommendation. For details, end-users should refer to (1) Factories andIndustrial Undertakings (fire precautions in notifiable workplaces) Regulation, Cap. 59V,Section 9 for storage of inflammable substances and (2) Dangerous Goods General from theFire Services Department.Storage of Medical Gas Cylinders/Containers4.92 The storage of medical gas cylinders must comply with the provisions of the DangerousGoods (General) Regulations. For details, end-users should refer to the Medical Gas SystemOperation Manual on cpo.home of HA intranet.33
(D) RECOMMENDATIONS ON DRUG ADMINISTRATION PROCEDURES IN THEWARDSNo medications should be administered to a patient if a drug order is unclear or when there isdoubt in the appropriateness and safety of the patients.Level of Nursing Personnel involved in Drug Administration4.93 Under normal circumstances, a Registered Nurse is competent to administer medications onhis/her own. However, it is advisable to have a second person counter check the processespecially in situations where skill, experience and familiarity with the clinical conditionsare required to ensure safe practice, such as with paediatric medication, intravenousinjections, dangerous drugs, cytotoxic drugs and drugs added to infusion fluids. In any case,nurses should exercise care to double check themselves and not to rely solely on others withregard to the checking process.4.94 Enrolled Nurses should work within their qualification and training. In normalcircumstances, they can administer medications, when delegated this duty by RegisteredNurses. In the case of the extended and expanded role of the Enrolled Nurse, an enablingcourse or clear guidelines should be provided.4.95 Nurse learners who have undergone training in medication administration and are deemed tobe competent, may administer medications under the supervision of qualified nurses.Order and Receipt of Drug Supplies from the Pharmacy4.96 All drugs orders should be sent (e.g. by fax or by NCR) to the pharmacies for vettingirrespective of whether the supplies of drugs are required. Prior to sending of the drugorders, authorized nurses should screen the information on the orders to ensure the correctpatient’s label has been affixed and all important information for drug dispensing andadministration have been clearly written.4.97 All “discontinued” medications on the MAR should be faxed to the pharmacy as soon aspossible so that unnecessary re-dispensing of discontinued drugs can be avoided. In thecases of urgent / uncertain situations, the pharmacy department should be called to confirmthe receipt of the drug orders.4.98 All drugs delivered to wards must by checked by the authorized nursing staff as soon as theyare received. Drugs with special storage instructions such as refrigerated items must be putin the refrigerator promptly. The patient’s name on each of the drug label and the name andcondition of each of the drug dispensed must be checked for accuracy and acceptabilitybefore putting them into the drug trolleys.34
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 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
Page 76 and 77: 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
Page 102 and 103:
QUALITY ASSURANCE IN DRUG THERAPYHO
Page 104 and 105:
Fig. 1: ADR voluntary reporting sys
Page 106 and 107:
PROCEUDRE FOR QUALITY COMPLAINTSONP
Page 108:
Part II Procurement Section, CPO1.
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