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

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COC(N) Paper 12/2004Approved by COC(N) at56 th Meeting held on 3 June 04Guidelines on Patient Self Medication(For Psychiatric In-Patients)IntroductionThe purpose of this paper is to introduce the guidelines on the implementation ofself-medication programme for psychiatric in-patients.Background2. Medication non-compliance is the major factor, which leads to relapse and accountsfor most psychiatric re-hospitalization. With the increased awareness of patient’s right, medicationeducation will enable the psychiatric patients to acquire knowledge on medication, to makeinformed choices and promote their commitment in the treatment plan.3. The self-medication programme has been implemented in Psychiatric in-patientservice as part of the rehabilitation training. It aims at enhancing the patients’ knowledge on drugclassification, the expected therapeutic effect / side effect and the proper storage of the drugs. Italso enforces the patients’ understanding on the importance of medication compliance and havingthe medication taken by self accurately.4. To standardize the practice among clusters, COC(N) decided to establish guidelinesto carrying out this programme for Psychiatric in-patients with input from Chief Pharmacist’sOffice.Definition5. Patient self-medication programme is a programme in which patients are educatedand given the responsibility to manage and to take their prescribed medication when in hospital ordischarged home.Objectives6. The objectives of the guidelines are :6.1 To heighten/maximize patient’s self-care ability6.2 To enhance patient’s drug knowledge and proper handling of medications6.3 To improve medication compliance6.4 To promote patient’s commitment in the treatment plan1
Operational guidelines7. Operational guidelines on implementation of the programme for individualpsychiatric hospital / psychiatric unit should be in place. The guidelines should be endorsed bylocal hospital Drug Committee and include the followings :7.1 Selective criteria of patients are : Scope of patient selection e.g. patient with history of non compliance Participation of the health care team in patient selection Mode of obtaining consent and its documentation7.2 Supply and storage of the medicationMechanism in place to state Agreement with the Pharmacy of individual hospital/ unit for the drug supplypolicy, provision of the individualized packing of medication, procedures inrequesting / revising / returning of drugs for self-medication etc. Appropriateness of the medication storage place in respect of patients’ safetyand accessibility and local hospital / unit structure Appropriateness of DD storage in respect of the Dangerous Drug Act7.3 Training and monitoring Availability of the training kits and assessment tools e.g. content of eachtraining session Personnel involved in the training and their responsibilities e.g. medical officer,nurse or pharmacist Protocol for stepping up and stepping down the training for individual patient Documentation of patients’ knowledge assessment and suitability for thepractical part after the theory sessions Documentation of patients’ self-medication practice and it should be in linewith the local hospital / unit policy on AOM e.g. to keep patient’s selfadministration form together with the MAR Level of supervision and mechanism in ensuring patients’ medicationcompliance in different stages of self-medication e.g. issuing of medicationreminder card for forgetful patients2
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ForewordMedication safety and provi
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Chapter 6 summarizes the specific r
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Chapter 6Conclusions and Recommenda
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CHAPTER ONETHE WORKING GROUPMEMBERS
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CHAPTER TWOTHE PROGRESS REPORT2.1 P
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CHAPTER THREEAREAS FOR IMPROVEMENT
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Existing In-patient Drug Administra
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CHAPTER FOURRECOMMENDED PRACTICES A
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Drug Name4.11 There should be a hos
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Electronic prescribing (Medication
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4.46 When the use of CM is permitte
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cytotoxic and central intravenous a
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4.72 Special precautions should be
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4.84 To prevent mixing up medicatio
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The Principle of Three checks and F
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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 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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