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

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Medication Incident <strong>Report</strong>ing Programme6.12One of the most important methods for preventing medication errors is for individual, unitor hospital to learn from the mistakes and problems that have already been encountered.It is recommended that each hospital should strengthen their mechanism for thereview of all medication errors and make appropriate recommendations orcorrective measures. Information on medication incidents should be discussed andpresented in the form of workshops and lectures for educational purposes.Electronic reporting through AIRS should be pursued.Adverse Drug Reaction <strong>Report</strong>ing Programme6.13HA has developed a comprehensive, ongoing programme for reporting, monitoring,reviewing and evaluating adverse drug reactions.It is important that each hospital should strengthen their mechanism to collectinformation on ADRs for analysis on a regular basis. Educational feedback shouldbe provided to the prescribers and other health care professionals.Implementation of MAR, CARS & Bar-code Topping Up Systems6.14MAR, CARS and Bar-code Topping Up systems are systems implemented by individualhospitals’ pharmacy department and have made a great impact on the drug administrationprocedure and have enhanced the drug distribution process. The importance of thesesystems has already been discussed in paragraphs 4.51, 4.52 & 4.74 (e). All these systemsare important components in the process of eliminating medication errors during drugadministration.It is highly recommended that these systems be implemented comprehensively in allHA hospitals in the absence of any better alternative at present.47
24 hours or Extended Pharmacy Service6.15The working party has acknowledged the need to provide a 24-hour or at least an extendedpharmacy service in acute general hospitals. A number of problems were identified in thein-patient drug administration procedure arising from the limitations in pharmacy servicehours.It is strongly recommended that a 24 hours or at least an extended pharmacy servicebe introduced in acute general hospitals when manpower and other resources areavailable.Aseptic Dispensing Services6.16Pharmacies are recommended to prepare and dispense medications in the most ready-toadministerform in order to minimize the opportunities for errors. Aseptic dispensingservices, such as TPN, cytotoxic and central intravenous admixture services, arerecognized as important pharmacy services to improve efficiency and accuracy throughstandardization and specialization.It is recommended that the provision of Aseptic Dispensing Services by thepharmacy be extended to or through clustering of service by the acute generalhospitals.Clinical Pharmacy Service6.17The importance of the Clinical Pharmacy Service and the benefits of Satellite PharmacyServices and Compliance and Refill Clinics have already been discussed in paragraphs4.54, 4.55, 4.56 and 4.57. A Clinical Pharmacy Service can undertake risk managementstudies, improve safety and quality as well as reducing the chances for medication errorsand enhancing a multi-disciplinary approach.It is recommended that priority be given to establishing Clinical Pharmacy Servicesin acute hospitals.48
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 46 and 47: LEVELSHAHOCE / DTOOLS & MECHANISMDU
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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