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Part Two

- Standards for medicines

Policy name

Handling high-risk medications (including concentrated solutions)

Policy number

 

Issue date and number

 

 

Review Date

 

number of pages

 

Section

All hospital departments


Politics:

* Identifying high-risk drugs by scientific names, collecting them in a separate list and distributing them to all medical service providers and dealing with the drugs included in the said list in the correct form according to the instructions for each preparation to ensure that the patient is not exposed to any therapeutic risks due to the wrong use of concentrated solutions without diluting them.

Purpose:

* Ensure that high-risk medications are handled with due diligence to ensure that the patient's health is not exposed to any therapeutic risks.

Definition:

* Dangerous drugs are drugs that cause serious dangers to the patient when used incorrectly, so a list is drawn up for them showing what are those dangerous drugs that need to be handled carefully to avoid any mistake in their use.

Working Procedures:

* The pharmacy manager, with the help of pharmacists at the hospital, draws up a list of dangerous drugs and solutions with high concentrations specified by scientific name and instructions for dilution, administration and observation.

* The pharmacy manager distributes the list to all therapeutic departments and units of the hospital.

* These medications are not placed in the regular departments and their presence is limited to critical Hot Area places such as (care, operations, emergency and kidney department) and their presence is limited to the departments inside the emergency vehicle.

* When using these drugs, the doctor is confirmed first and then a two-by-two review of the nursing before giving them.

* When preparing and preparing these medicines, be in a place with good lighting and away from any noise or interruptions.

* When storing these medicines, a red label is placed on the container box (packages) of these medicines and it is a separate place from ordinary medicines, provided that this label contains the following data:-

- Scientific name of the drug

- Focus;

- Pharmaceutical form

- Expiration date 

* When dispensing these medicines, the pharmacist puts a red mark on each ampoule or bottle, and in the case of dispensing large quantities, the pharmacist can instruct the nurse to put this mark on each one alone.

* When placing drugs that are similar in pronunciation, shape, or both, the packages are separated and not placed next to each other, in addition to writing clear addresses on the packages.

* A drug reference is set for each section, including (use of each drug-method of administration – doses – side effects-standards to be followed on use and preparation).

· When giving anticoagulants, the attending physician does the following :

o use protocols indicating the initiation and continuation of anticoagulant therapy and the required follow-up analyzes.

O documentation of pre-treatment and current INR in the medical record.

o when giving anticoagulants, doses are correlated with the results of the laboratory.

o use a pump if heparin is administered intravenously in a continuous manner.

o health education of the medical team, the patient and his family regarding :

(Importance of follow – up – adherence-drug-Food Interactions-adverse reactions).

* When administering narcotic drugs, the pain is evaluated by a doctor and taken as necessary in case of severe pain.

 Responsible Person :

* Pharmacists

* Doctors

* Nursing staff

Models:

· List of high-risk drugs

References:

* International standard standards for patient safety.

* Egyptian accreditation standards

Preparation

Review

The trust


List of high-risk medications

Policy name

List of high-risk medications

Policy number

 

Issue date and number

 

 

Review Date

 

number of pages

 

Section

All hospital departments


High-risk medications

medicament name

M

medicament name

M

Heavy Markin

22

Atracurium ( Atracurium)

11

Epanutin (Phenytoin)

23

Succinylcholine

2

Inderal (propranolol )

24

Izmeron(rocuronium)

3

Bisoprolol ( Concor)

25

Epinephrine (epinephrine)

4

Cordarone (Amiodarone)

26

Noradrenaline (Levovirin)

5

Digoxin (Cardexin )

27

Ephedrine

6

Heparin

28

leumethacin (indomethacin )

7

Klaxan(enoxaparin)

29

Atropine sulfate

8

Marifan (Warfarin)

30

Povol (Propofol)

9

Sidonase    (streptokinase )

31

Catalar(ketamine)

10

Potassium chloride

32

Isoflurane

11

Magnesium sulfate

33

Sevoflurane

12

Naloxone (Narcan)

34

Intraval (thiopental)

13

Hypertonic salt solution

35

Xylocaine (lidocaine)

14

Glucose 25%

36

Markaine (bupivacaine)

15

Aminophylline

37

Fentanyl

16

insulin

38

With breasts

17

Omnipack (radio dye)

39

Tramal ( Tramadol )

18

Cidophag (metformin )

40

Neoryl ( Diazepam)

19

Isobuten(verapamil)

41

Dormicum (Midazolam)

20

Tryptizol (acetriptyline )

42

Kalmibam (Bromazibam)

21


These medications have a high risk of misuse, so they must be handled with extreme caution

Preparation

Review

The trust

 

 

 


The policy of obtaining a list of the treatment that the patient takes upon admission to the hospital and upon discharge

Policy name

Obtain a list of the treatment that the patient takes when entering the hospital and upon discharge

Policy number

 

Issue date and number

 

 

Review Date

 

number of pages

 

Section

All hospital departments


Politics:

* Obtaining the patient's current treatment list so that it is complete and documented at the beginning of the patient's admission to the hospital.

* Give the patient a list of his entire treatment with an explanation of the method of use when he is discharged from the hospital.

Purpose:

* Achieving patient safety while in the hospital by committing to the patient's current treatment list so that the patient does not stop taking the medicine, which may lead to affecting his health condition or postponing his surgery for which he was hospitalized.

* Achieving patient safety when discharged from the hospital or transferred to another place by giving the patient a list of his treatment so that he does not stop and his health condition is affected.

Definition:

* The doctor will check the patient's current treatment upon admission.

Working procedures upon entry :

* The doctor evaluates the patient upon admission and asks him about the medications he is taking at home and records this in the patient's patient history form.

* The doctor evaluates the patient based on the results of Radiology, medical tests and the patient's current treatment.

* Based on the findings of the above-mentioned examination and evaluation, the doctor develops a treatment plan, taking into account the patient's current medications to ensure the continuity of health care, taking into account the writing in Arabic, without using Unknown or known abbreviations.

* The pharmacy department publishes a list of abbreviations that should not be used in writing medicines, to be reviewed every two years to add or delete any abbreviation.

Working procedures at the checkout :

* The doctor will explain fully to the patient about the state of Health at discharge in a clear, simple and understandable way.

* The doctor writes the discharge treatment for the patient with the medical record, follow-up card and discharge summary discharge summary with an explanation of the treatment for the patient.

* The department nurse delivers the follow-up card and discharge summary to the patient.

* When transferring / transferring a patient to another hospital, the treatment performed in the hospital is written in the outpatient transfer/referral form and the discharge summary.

In charge :

* Doctors.

* Nursing staff.

* Pharmacy.

Models: 

* A list of abbreviations that should not be used in writing medicines

·   (discharge summary).

* External transfer/referral form.

References:

* International standard standards for patient safety.

* Egyptian accreditation standards

Preparation

Review

The trust