Safe Use of Medication in Hospital Pharmacy

ASHP Guidelines for Safe Use of Medications in Hospitals

Labelling and Medication Containers

• Labelling should be done by a pharmacist or under the supervision of a pharmacist
• Medication labels should be typed or machine printed, and not handwritten or superimposed on other labels
• Labels should bear identification of the pharmacy and accessory or caution labels should be used where necessary
• The metric system should be preferred over the apothecary system

Inpatient Dispensing

• Labels should indicate the amount of drug dispensed, and the date of expiry for perishable drugs
• Route of administration and dilution technique (if needed) should be mentioned on the label
• Proper storage containers should be used to maintain stability and integrity of medicines
• Medications brought by patients should be properly checked, recorded, and labelled as patient own medications

Outpatient Dispensing

• Labels should bear additional information than general labelling, including patient name, non-propriety name of medicine, strength, date of issue, and initials of the dispensing pharmacist
• Name of prescriber and address, as well as caution and direction labels, should be included

Drug Cabinets in Nursing Units

• Adequate space, lighting, ventilation, and working space should be provided
• Inner lockable narcotic cabinets, and adequate means of security, should be present
• Particular arrangement in accordance with established plan for the hospital should be followed
• Controlled drugs should be inventoried, recorded, and inspected regularly

Medication Orders and Cards

• Medication should be dispensed only on written order of a physician, with exceptions covered by written policy
• Medication order cancellation policy should be devised
• Medication order should include name of medication, dosage in metric system, signature or ID of physician, route, and date of order
• Medication card should contain all identification details of the patient and the medication prescribed with start and stop date

Preparation and Administration of Medications

• Ascertain that the dose is not administered, and selection medication from cart and check from medication card for correct medication, timing, and route
• Give full attention while preparing medication for administration
• Read the label three times, and pharmaceutical calculations should be checked by other nurse or ideally by a pharmacist

Recording of Medications

• All medicines prescribed, dispensed, or administered should be recorded to patient medical records
• There should be an established procedure for recording of patient medical history including medications and diagnosis

Medication Errors

• Each hospital should have a clear statement policy for all medication errors
• Report should be shared with management within the defined time limit, and corrective actions should be noted

Medication Interaction Surveillance

• Each hospital should have a drug interaction surveillance program run by a pharmacist
• The program should include preparation of drug interaction reporting form, method to check drug – drug, drug – food, drug – lab reports interactions, and recording of identified interactions and extent of effect

This quiz covers ASHP guidelines for safe medication use in hospitals, including labelling, dispensing, and preparation of medications. It's a part of Pharmacy Practice-IVA course taught by Dr. Syed Saad Hussain.