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

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Quality Complaints on Pharmaceutical Items5.9 A quality complaint regarding a pharmaceutical item is defined as concern that is raised ondiscrepancies in efficacy, appearance, packaging, possible contamination or any othercircumstances observed that may jeopardize or cause reasonable doubt on the routine andintended utilization of that item.5.10 In order to provide safe and effective pharmaceutical items to all patients, the qualitycomplaints should be handled in a systematic manner. The procedure must be complied withand all cases of quality complaints must be reported by using the standard report form. Fordetailed procedure, Appendix 17 should be referred to.5.11 Whenever an alert with batch suspension is issued, immediate action must be taken toquarantine all affected batches in all stores both within and outside pharmacy in the hospital.Close liaison with nursing staff should be maintained in order that the situation is fullyunderstood by all parties concerned. All subsequent recommendations including productsuspension, replacement, withdrawal or recall should be executed immediately and to allward levels.Drug Recall5.12 Pharmacists must comply immediately with any warning or recall about defective medicines.A drug recall system must be maintained so that all problematic batches can be traced andretrieved in order to protect patients from any harmful effects due to defective medicines.5.13 All drugs should preferably be kept in their original containers with their unique lot/batchnumber. If it is necessary for drugs to be transferred to another container, such as pre-packs,the retraceable lot/batch number should be marked on the label of the drug item.5.14 When a drug recall is activated, pharmacy must notify all parties concerned immediately,such as the unit head and nurse-in-charge, of the product to be recalled, the reason for itsrecall and the batch number involved.5.15 All affected stock must be quarantined pending further instructions.43
CHAPTER SIXCONCLUSIONS AND RECOMMENDATIONSThis report attempts to address the very important issues of patient safety, system efficiency andquality improvement related to the in-patient drug administration process, which includes drugprescribing, dispensing and administration. The majority of activities related to the assessment ofthe in-patient drug administration process are driven by HAHO but promulgated and implementedin the individual hospitals. In order to achieve the objectives of this report, effective teamwork isessential particularly in the promulgation, dissemination and implementation of the proceduralguidelines and recommended practices to all HA hospitals.Team Approach to the Promulgation, Dissemination and Implementation ofProcedural Guidelines6.16.2It is recommended that a team approach involving the HAHO, individual hospitals’top management such as the CCE / HCE, COS and the professional front-line staff,should be used in the promulgation, dissemination and implementation of theprocedural guidelines in this report.Doctors, nurses and pharmacists have different but integrated roles to play in the wholeprocess of drug administration. They should work together as a team with an ultimateaim of providing quality patient care. Such team work is particularly important inHospital DTC, Department Quality Assurance Programme/Risk ManagementForums and Review Panels on medication incidents.The Mechanism of the Team Approach to the Promulgation, Dissemination andImplementation of Procedural Guidelines6.3 The following flow chart illustrates an example of the mechanism of the team approachand provides a structural accountability framework for the effective promulgation,dissemination and implementation of the procedural guidelines in hospitals.44
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 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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