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

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CHAPTER ONETHE WORKING GROUPMEMBERSHIP OF THE WORKING GROUP1.1 The Working Group was appointed to review and update the contents of the <strong>Report</strong> onDrug Administration Procedures and Practices in Public Hospitals (2000 edition). All thesafety issues associated with the whole process of drug administration would be reviewed.Its membership was selected from the three professional groups involved namely, doctors,nurses and pharmacists from the institutions under Hospital Authority.The composition of the working group is as follows:Convenor:Mr Pak Wai LEEMembers:Dr S Y AUDr Eric CHANMs C C CHENGMs Sau Chu CHIANGMr Dalton CHONGMs Pauline CHUMr William CHUIMs Betty KUDr C B LAWMs Anna LEEDr Benjamin LEEDr Petty LEEMr Michael LINGDr Siu Fai LUIMr William POONDr Cheung San TJIUDr Tak Cheung WONGMr Alan WONGDr Loretta YAMSecretary:Ms Teresa NGANChief Pharmacist, HAHOService Director (Community Care), NTWC / Consultant(Geriatrics), TMHExecutive Manager (Nursing), HAHODepartment Operation Manager (Medicine & Geriatrics), KWHSenior Pharmacist (Pharmacy Practice Management), HAHOManager (Nursing)2, HAHOCluster Coordinator, NTWC (PHARM)HKWC Chief of Pharmacy Service / QMHPHA DMDepartment Operation Manager 5, Team (3,5,7), KCHConsultant (Medicine & Geriatrics), PMHSenior Pharmacist (Professional & Clinical ServicesDevelopment), HAHODepartment Manager (Pharmacy), PWHPharmacist, (Professional & Clinical Services Development),HAHODepartment Manager (Pharmacy), KWHCluster Co-ordinator (Pharmacy), NTEC / Service Director(RM&QA), PWH / Co-ordinator (Clinical Services), PWH /Consultant (Medicine), PWHSenior Nursing Officer (Central Nursing Division), UCHResident (Surgery), UCHChief of Service (Medicine), TKOHGeneral Manager (Nursing), QMH/TYH/SYPCSC(Medicine), HKEC / Clinical Coordinator 4, PYNEH / Chiefof Service (Medicine), PYNEHExecutive Partner (CPO), HAHO7
TERMS OF REFERENCE1.2 To identify gaps between the recommended procedures and actual practices and torecommend guidelines for improvement.1.3 To review and update the <strong>Report</strong> on Drug Administration Procedures and Practices inPublic Hospitals.OBJECTIVES1.4 The following objectives were laid down to guide the deliberation of the Working Group:(a) Patient SafetyThe Working Group regards patient safety as the single most important objective in theentire process of drug administration. The latter is composed of the prescribing, dispensingand administration processes. It requires that a continuous effort is made by all the threeprofessional groups, namely doctors, nurses and pharmacists and this must be coordinated.Procedural guidelines should be drawn up and enforced to maximize patient safety, facilitiesand equipment must be optimized to minimize medication error.(b) Professional StandardsIn an endeavour to devise policies to optimize patient safety, the Working Group acceptsthat there are professional standards relevant to the medical, pharmacy and nursing gradesthat should be considered. Taking into account their different roles, these professionalstandards must be coordinated and incorporated into procedures and practices, so thatmedical, pharmacy and nursing staff can discharge their duties smoothly and effectively.(c) Optimizing the Utilization of ResourcesConsiderations must also be given to optimize the systems used for drug administrationprocedure within the institutions. Procedures must be streamlined to utilize better theresources available, whether it be manpower, drugs or facilities.8
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 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 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
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Appendix 3aLists of HA-wide Approve
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DRUGTeniposideABBREVIATIONVM-26Thia
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Appendix 3b“Do Not Use Abbreviati
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Appendix 4Schedule for the Administ
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Appendix 5Mechanism for the Managem
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4. As with all medications, there s
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Appendix 6HA Guideline on Safe Mana
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2.1 Concentrated potassium chloride
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Appendix 7Supply of Antidotes and D
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複本 Antidotes and emeg drug lis
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Appendix 8Guidelines for Supply of
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substitution with other drugs in ac
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Appendix 9Samples of the Line Label
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Appendix 10Guidelines on the use of
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Appendix 11Guidelines on Patient Se
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Operational Guidelines7. The operat
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COC(N) Paper 12/2004Approved by COC
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7.4 Evaluation Record and report th
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DISPOSAL OF HOSPITAL PHARMACEUTICAL
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Appendix 14Guidelines on the Handli
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Appendix 15Medication Incident <str
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Hospital Authority Medication Incid
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QUALITY ASSURANCE IN DRUG THERAPYHO
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Fig. 1: ADR voluntary reporting sys
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PROCEUDRE FOR QUALITY COMPLAINTSONP
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Part II Procurement Section, CPO1.
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