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

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LEVELSHAHOCE / DTOOLS & MECHANISMDURCCCE /HCEDTCGM (N)COS /CSCDM (Pharmacy)NursingstaffMedicalstaffPharmacystaffTEAM WORK6.4 The commitment and support from the HAHO and the top management of the individualhospitals are very important. In order to disseminate the procedural guidelines effectively,hospitals should prioritize their resources for the purpose of conducting more trainingworkshops, seminars and forums and train-the-trainer workshops for all staff concernedand especially front-line staff.6.5 Individual hospitals’ DTC should include doctors, nurses and pharmacists. They shouldadopt the procedural guidelines and enhance their roles and responsibilities tocoordinate the various professionals in the promulgation, dissemination andenforcement of guidelines, to monitor and review cases of medication errors, and toaudit staff adherence to these guidelines.6.6 The drug administration guidelines are to be widely distributed and easily accessed byevery doctor, nurse and pharmacist. Wherever necessary, relevant parts of theguidelines should be extracted for use and reference by the relevant staff groups.6.7 The establishment of a mechanism for effective communication between management andfront-line staff should be encouraged. Regular feedback should be obtained from thevarious professional groups, so that problems can be identified and effectiverecommendations/corrective measures made.45
To achieve these objectives, the following range of development programmesare recommended to be implemented in all HA hospitals.Standardization on Medication Administration Processes6.8The working party has acknowledged the importance of standardization of medicationprocesses in establishing uniformity in practice to prevent medication incidents. Anumber of areas have been identified and recommended as priority areas for suchstandardization.It is strongly recommended that standardization should be implemented at theappropriate level such as specialty, hospital, cluster or HA-wide. These include thestandardization of• MAR forms (cluster)• Times of administration of medications (HA)• Dosing and dilution methods of IV solutions (hospital / cluster)• Medications used in resuscitation (specialty / hospital / cluster)Information Technology in Patient Care6.9 The introduction and extensive use of information technology in the areas of prescribingand pharmacy service have had a positive impact on existing practices. The importance ofinformation technology in patient care has already been discussed in paragraph F ofchapter four.6.10 Successful application of the various information technology systems, e.g. PMS, theCARS, the CDDH, the Bar-code Ward Stock Topping Up has brought significantimprovement in the pharmacy service. It facilitates putting many principles of the drugadministration procedures discussed in this <strong>Report</strong> into practice and provides impetus forfurther development. The systems should be extended to more HA hospitals.6.11Use of the MOE module for discharge-patients and out-patients in the CMS improvesclinicians’ access to patients’ drug information and the prescribing process. Furtherenhancement of the medication order entry functions and integration with the pharmacysystems should be developed to improve the utilisation of the systems and to providedecision support to clinicians in drug prescribing and dispensing.It is recommended that feasibility study should be conducted on the development ofin-patient MOE. Robust mechanisms to prevent the prescribing of potentiallyharmful medications to patients with known allergy must be established.46
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 44 and 45: Quality Complaints on Pharmaceutica
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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