Drug Management

MANAGEMENT OF MEDICATION

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Introduction

·       It is a strategy for engaging with patients and care givers to create a complete and accurate medication list using various processes

·       Basically it involves the basic steps

o   Prescribing

o   Verifying

o   Dispensing

o   Administering

o   Monitoring

o   Reporting

·       Major outlines for the management of medications are

o   Abbreviations used

§  BD (Twice a day)

§  TDS (Thrice a day)

§  Q6H (Every 6 hrs) etc.

o   Medication Reconciliation

§  Past medication history

§  Transfer history including the drug

·       Name

·       Strength

·       Frequency

·       Route

·       Quantity

o   Storage of Medicines

§  Labelling & storage should be

·       Clean

·       Safe

·       Secure

§  Cross checking

§  High risk should be store clinically necessary

§  LASA drugs should be stored physically apart from each other

§  Refrigerator medicines should be stored at 2-8 degree Celsius

§  Drug list should be displayed

§  Near expiry (3 months before expiry)

o   Administration of Medications

§  Medication are administered by those who are permitted by law to do so

§  Verification of medication order

§  Patient is identified before administration

§  Labelled out the prepared medication

§  Avoid catheter and tubing’s misconnections during administration

§  Administered medication should be documented

§  Verify the strength/route/timings before the administration

o   Use of Multi-vials

§  Multi-vials are the vial of a liquid form of drug that contain more than 1 dose of drugs

§  Should have a label of opening date

§  Maximum 10 pricks

§  Discard the vial after 28days

o   Medication Chart

§  All prescription should be in CAPITALS

§  Illegible prescription will be initiated after single strike

§  A fresh medication order has to be written for every drug

§  Do not use correctors

§  Verbal order should be highlighted with red color

o   Incidents (ADR)

§  Adverse drug reactions is harm direct caused by the drug at normal doses during normal use

§  The ADR must have to be documented because

·       To prevent future injuries

·       To clarify the side effect profile of a drug

o   Medication Error

§  Examples of medication errors include misreading or miswriting a prescription

§  The classification is as follows

·       Near miss (corrected before reaching to patient)

·       Adverse event (undesirable effect with the use of a drug)

·       Sentinel event (event that results in death)

o   Narcotics/Chemotherapeutics/Radioactive Drugs

§  These drugs should be used safely

§  Stored securely

·       Double lock method

·       Key should be handled by 2 staffs

·       Should be prepared safely

·       Should be administered by qualified personnel

§  These drugs should be documented appropriately in the specified registers

o   High Risk Medications

§  High risk medications are drugs that bear a heightened risk of causing significant patient harm when they are used

§  Labels them from red color

§  Standardizing the

·       Ordering

·       Storage

·       Preparation

·       & administration of these drugs

§  At least 2 qualified healthcare professionals shall independently double check the correct

·       Patient

·       Drug

·       Dose

·       Dose calculations

·        Route of administration

·       Label

o   LASA

§  Look alike and Sound alike drugs

§  Visually similar in physical appearance or packaging and names of medications that have spelling similarities and/or similar phonetics

§  Confusing medication names and similar product packaging may lead to potentially harmful medication errors

§  Always use color code

§  Look alike – Green

§  Sound alike – Pink

§  Keep physically apart

§  Tall man letters for sound alike

 

Video Description

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