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Patient safety

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14.6
This is an example of the application of e-technology for a hormone drug Premelle to prescriber’s system. If the patient is on the childbearing age of 15-44, as she is prescribed the drug, system will pop-up to ask for physician to check one of the item to avoid possible harm for the pregnant women.
47
This is the screen of computerized physician order entry system in my hospital. We provide a user-friendly query systems for physicians. For example, physicians can click query buttons to check electronic formulary, the package inserts, and drug appearance and classifications. On the drug lists, we remarks for special usage, and highlight solutions with a green background. We also describe the clinical uses and stock status.
89.7
We have built up more than 30 error-proofing mechanisms in computerized physician order entry systems. This system can check prescriptions and pop-up warnings for duplicate orders, overdose, Drug interaction and so on.
112.8
In Taipei Veterans General Hospital, we maintain our formulary by pharmacy department and published regularly. For the paper version, we publish every other year. For the web-based formulary, we integrated the formulary into our health information system and clinical management system to provide the updated information for all the health care professionals. The e version formulary will be updated every other week. We also build up our own formulary app to facilitate the delivery of the medication information.
157.8
P&T committees have always addressed medication safety issues. However, as medication errors have received increased scrutiny, and more is understood about the process failures that contribute to such errors, P&T committees have more opportunities to address patient safety issues. The P&T committee should systematically address patient safety as part of deliberations. Opportunities for including patient safety in P&T committee deliberations
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include the following: When evaluating a medication for inclusion on the formulary, the P&T committee should consider adverse effects, issues in preparation, sound-alike or lookalike potential, and dosing or administration issues. Assessments should be conducted to identify potential safety concerns posed by use of the medication. The P&T committee should make recommendations for managing identified risks. Organizations, in collaboration with the appropriate committees, should undertake projects to proactively assess risk in medication-use processes. The use of high-risk medications or major system changes offer opportunities to perform proactive risk assessments. Failure mode and effects analysis can be used to structure these assessments. The P&T committee should consistently review medication-event data, including data on near miss, and make recommendations to prevent future events.
278.5
The P&T committee should conduct targeted quality improvement projects to improve the safety of specific medications or to evaluate the processes involved. When reviewing policies, the P&T committee should ensure that the policies adequately address the potential risk issues. The P&T committee should support evidence-based fail-safe technique for example, the bar-coding to prevent medication events The P&T committee should review information available on safety or events reported by other organizations to identify ways to prevent medication events and disseminate the information to health care providers, when appropriate, patients. Resources on medication safety should be routinely reviewed to identify potential issue an organization could address. Examples of resources include the Institute for Safe Medication Practices and Medwatch
357.1
In summary, The Pharmacy and Therapeutics Committee, or equivalent body, comprised of actively prescribing physicians, pharmacists, and other health care professionals, is the mechanism for administering the formulary system, which includes developing and maintaining the formulary and establishing and implementing policies on the use of drug products. Formulary system is the multidisciplinary, evidence-based process employed by an organization to select and use medications, that offer the best therapeutic outcomes while minimizing potential risks and costs for patients. Ongoing formulary maintenance and routine drug evaluations are key elements in the process.
419.4
Technology offers many opportunities to make those processes more effective. Communicating the actions related to medication use is a constant challenge that organizations need to address. The formulary system, when properly designed and implemented, can promote rational, clinical appropriate, safe, and cost-effective drug therapy. As a drug expert, the pharmacist plays a critical role in the management of medication use can assure safe, efficacious and cost-effective drug use through the formulary system. This is the end of this topic. Thanks for your attention!

Dr Chang finishes this activity with technologies that help to manage formulary and how PTC maintains prescription safety.

Key points

Technology can be used to aid formulary maintenance. Applications can be incorporated into the computerized physician order entry (CPOE) system allowing physicians to check electronic formulary, the package inserts, and drug appearance and classifications easily. There are also error-proofing mechanisms.

The PTC should systematically address patient safety as part of deliberations.

They should:

  • Carry out medication evaluation, including the adverse effects, issues in preparation, sound-alike or lookalike potential, and dosing or administration issues.

  • Proactively assess risk in medication-use processes. Failure mode and effects analysis can be used to structure these assessments.

  • The P&T committee should consistently review medication-event data, including data on near misses, and make recommendations to prevent future events.

  • Conduct targeted quality improvement projects to improve the safety of specific medications or to evaluate the processes involved.

  • Access potential risks in policies.

  • Provide evidence-based fail-safe techniques.

  • Keep updated with patient safety information or events reported by other organizations.

Share and learn:

How is technology applied in your hospital to implement PTC policies?

Looking at the list of responsibilities on patient safety, have you ever carried out any of these initiatives?

This article is from the free online

Good Pharmacy Practice: Medication Management

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