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Download NUH list of critical drugs which should not be omitted or delayed
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Transcript
NUH List of Critical Drugs which should not be omitted version 6, Feb 2017 NUH list of critical drugs which should not be omitted or delayed To make sure that drugs are most effective and to prevent patients from suffering harm, it is important for some drugs to be administered at specific times. The following list of drugs are considered critical and must never be omitted or delayed without a clinical reason which has been discussed with the medical team. The reason for the omission and a plan of action must be documented on the Medicines Management Plan found on the back pages of the Prescription Chart. If you are unfamiliar with a drug name, you must check to find out what it is prior to prescribing, ordering or administering the drug. This list is not exhaustive. There will be other medicines that are only used in specialist areas where timeliness of administration is also crucial. Also refer to the local list in use in your specialist area where one exists. ALL medicines used in emergency situations FOR EXAMPLE: resuscitation and anaphylaxis drugs, reversal agents /antidotes, glucagon, oxygen, salbutamol, inotropes, fluids Anti-coagulants -prophylaxis and treatment (enoxaparin, heparin, warfarin, rivaroxaban, apixaban, dabigatran, phenindione, nicoumalone (acenocoumarol)) Anti-epileptics Anti-infectives (Antibiotics, Antivirals, Antifungals, Antiretrovirals, Antimalarials , MRSA decolonisation) Anti-parkinson medicines Insulin Steroids (oral and parenteral) Strong opioids prescribed regularly for acute or chronic pain All drugs should also be given as close as possible to the prescribed time & must be administered within half the dosing interval e.g. If prescribed 6 hourly, must be given within 3 hrs of the prescribed time, Obtaining supplies of critical medicines Critical medicines are held as stock on wards that regularly use these medicines. The flow diagram overleaf shows how to obtain supplies if the medicine is unavailable on your ward. Reporting omission of critical medicines The omission or delay of critical medicines is a patient safety incident and must be recorded on DATIX. For further information please see the NPSA alert RRR009 and the NUH Medicines Policy chapters on Prescribing, Administration and Supply of Medicines from Pharmacy. Ratified by MMC February 2017 Review date February 2019 Not to be used after February 2020 Page 1 of 2 NUH List of Critical Drugs which should not be omitted version 6, Feb 2017 Flow chart for obtaining Critical Drugs at NUH Yes WARD STAFF- Is the critical medicine available on the ward? Correctly administer and document all doses given No CHECK: Have Pharmacy signed the chart to indicate a supply has been made or that the item is held as stock on the ward or the patient’s own drugs are available? Have all Pharmacy Envopaks been unpacked? Has the patient recently changed wards? Have non-stock medicines and patient’s own drugs been transferred with the patient from the previous ward? Yes NCH Campus –has the Pharmacy locker been checked? WARD STAFF- Is the critical medicine available on the ward? No No Yes Is the Pharmacy open? CHECK: Look on the Pharmacy homepage on the intranet for opening times No Bleep the on call pharmacist via switchboard and request an urgent supply. ONCALL PHARMACIST Is the medicine available in the Emergency Drug Cupboard? Yes Direct ward staff to obtain a supply from the Emergency Drug Cupboard No Bleep your ward pharmacist and request an urgent supply. CHECK: Look on the Pharmacy homepage on the intranet for details of the Ward Pharmacist Schedules and the name & bleep number of the person providing the clinical pharmacy service to your ward today. If unable to contact Ward Pharmacist, then an escalation plan is available on the Ward Pharmacist Schedule page. No Is the medicine available from other wards on the same campus? Make an urgent supply from Pharmacy. Contact the ward immediately when the drug is ready. Yes Direct ward staff to obtain a supply from a stockholding ward on the same campus Ratified by MMC February 2017 Review date February 2019 Not to be used after February 2020 Page 1 of 2