Reviewed By- Dr Vijay Agarwal Dr Chander Mohan Bhagat Dr Lallu Joseph PRESENTATION ON MEDICATION SAFETY Presented by : Dr Abhijit Amiya Kumar(PT), Dr Venkatesh Sathiraju, Mr. Murali S Narayana , Ms. Lima Mathews , Ms. Junaiha KP, Dr Arya R V) Reviewed By- Dr Vijay Agarwal Dr Chander Mohan Bhagat Dr Lallu Joseph

Definition Medication safety is defined as freedom from preventable harm with medication use. (ISMP)

Components of Medication safety Prescription indenting Dispensing Administration Monitoring Documentation

Remedies for Medication safety BLOCK letter Clear And Legible Hand writing Uniform Location for Prescription Name of the drug Strength Frequency Right Route Before or after food Education regarding food drug & Drug Drug Reactions Correct Prescription

Accurate Indenting Recheck before indenting Correct patient Correct drug name Correct strength Double check the high alert drugs Recheck before indenting

Safe dispensing Right drug Correct strength Check the package of the drug. Intact seal Any discoloration Double check the medication before dispensing Check the Expiry date Follow FIFO method

Safe administration Right Patient Right Drug Right Dose Right Route Check the patient Identifier (Name & IP number) Right Drug Check The drug As per the prescription (Brand name & Composition) Right Dose Check The strength of the drug( Ex-Calpol 500mg or 650 mg ,Proper calculation of dose in case of pediatric & chemo medications) Right Route Should b e given as Prescribed(IV,IM,Oral,Subcutaneus) Right time Medication Should be administered as per the frequency(OD,TDS OR BD) Right documentation Documentation of the Medication administration should be done in the medication card .Sing by administering nurse & counter sing by the senior incharge.

Safe Monitoring After Anesthesia drug After Chemotherapy Drug High Risk & Emergency Drugs After Sedatives & Narcotic Drugs Monitor the effect & side effect of the drug administered Incase of any ADR ,inform the doctor

Should be sing By h nurse given & counter signed by the in charge Safe Documentation If any Medication is modified or Stopped d then the consultant has to document it properly. Any verbal order should be documented and signed by the doctor within 24 hours Should be sing By h nurse given & counter signed by the in charge Documentation of the medication administration Should be in the medication Card

Stake Holders In Medication safety HCO Doctors Nurses Pharmacy Quality Department

Role of HCO Licenses –Retail licenses, wholesale license, narcotic and psychotropic drug license Recruitment of Qualified ,trained & Experienced manpower –Pharmacist, Doctors, nurses Formation of Pharmacy & therapeutic committee Developing Quality culture

Role of Doctors Rational prescription of medication as per the clinical conditions Prescription in the medication chart Standardized prescription with dose , Route, frequency Use legible Capital letters , Generic names with Brand name Approved abbreviations should be used Special screening for Allergies, precaution for drug-drug and drug- food interaction Patient education Monitoring Medication Errors & ADR Antibiotic stewardship & Surgical antibiotic prophylaxis Help in making formulary

Role of Nurse Avoid indenting error- Double check before indenting Check and receive the medicines . Medication reconciliation Knowledge about the MOM policies (Verbal Orders ,narcotic ,Home medication etc) Ensure 6 rights for safe medication administration .

Role of Pharmacy Storage As per manufacturer guidelines Temperature and humidity to be monitored Narcotics under double lock & Key System LASA to be stored separately Emergency medicines uniformly stored (crash cart) High risk medication to be stored separately Storage of medication as per generic name and strength of medication

Proper inventory control Follow FIFO Policy for local purchase in case of stock-out Re-check while dispensing the drugs Policy for cut-strip medication Maintain proper TAT

Role of Quality Department Internal Audits As per NABH guide lines Training Monitoring the indicators RCA CAPA

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