Published on 14 June 2023

Issue 68 : June 2023

ARE YOU READY FOR NSQHS ACCREDITATION?
Namita Warrior & Irina Rigoli, Pharmacy Department, References

The National Safety and Quality Health Service (NSQHS) Standards present a  standardised and uniform benchmark of the level of care that healthcare consumers across the nation can anticipate from health service providers. Western Health is required to undergo mandatory assessment against the eight NSQHS Standards every three years (last survey was carried out in March 2020). 1

The NSQHS Standards comprise eight domains, which are as
follows:

STANDARD 4: Medication Safety Overview 2,3

What is Standard 4? The aim of this standard is to ensure competent clinicians safely prescribe, dispense and administer appropriate medicines to patients who are informed about their medicines
How do you engage patients with medication management? Explain what the medication is and why you are administering it;
Ensure the pharmacist and medical team is aware of any medication related issues and is available to discuss medications with each patient before discharge
What safety checks are required before prescribing, dispensing, or administering a medicine? Follow the 5 RIGHTS;
Use Medication Administration Wizard (MAW) where available;
Medication Administration Record (MAR) Summary
How would you report a medication error? Notify treating team of any incident that involves prescribing, supplying or administration;
Inform nurse/midwife in charge;
Log all medication errors or near misses on Riskman including feedback to patients/carers
Can you name some high-risk medicines? APINCHs Medicines:
A – Anti-infectives;
P – Potassium and electrolytes;
I – Insulin;
N – Narcotics and other sedatives;
C – Chemotherapeutic Agents;
H – Heparin and other anti-coagulants;
S – Systems (Medication Safety Systems such as independent double checks, etc)
What additional safety steps are required for prescribing, dispensing and administering APINCHs Medicines? Area specific practices;
Storage requirements;
Limited Access
Where would you document medication allergies and adverse drug reactions (ADR)? EMR (WTH, FH, SH, SDH) IPM/CPF (BMM);
Current paper drug chart with designated ADR section (each page); Complete Riskman for an ADR;
Inform Pharmacist and supply an ADR alert card to the patient/carer
Where would you find Medication Management safety incident data for your area? KHWD Board / WH Clinical
Incident Dashboard;
Error reporting (Riskman);
ADR Reporting;
Local Quality Improvements projects
Where would you find resources to support you with medication management? For procedures – PROMPT;
For formulation/dosages – contact treating doctor or pharmacist;
For ordering medications in business hours – medication request through EMR;
For ordering medications out of hours – global imprest on intranet
For specific medication safety
concerns – contact the ward pharmacist

 

RESOURCE CENTRE

The following resources have been compiled to assist staff in familiarising themselves with the NSQHS Medication Safety Standard and preparing for survey compliance:

 

COMMENTARY

Leanne Nuske, AD of Nursing & Midwifery – Safer Care

The National Safety and Quality Health Service (NSQHS) Medication Safety Standard together with the Western Health (WH) best care framework ensures clinicians are providing safe care to reduce the risk of patient harm. We do this by assuring clinicians safely prescribe, dispense, administer and monitor medicines and keep WH consumers informed about what medicines are prescribed, that they understand their medicine needs and risks, and that they are actively involved in the decision-making process. The medication standard ensures that WH has implemented organisational-wide governance and processes to promote medication safety by using a credentialing and scope of clinical practice process to guarantee that patients receive the best care at Western Health.

 

 

Med Safety Quiz Answers

(The Quiz was published in April’23 Newsletter)

1. FALSE
Free texting medication can take longer to fill out required fields, as well as much higher rate of errors.

Free text medications are NOT added into the EMR’s in-built warning system (clinical decision support).

There will be no pre-filled administration documentation, interaction and allergy checking.

2. TRUE
Free text medications are only to be used for medications that don’t exist in the EMR. Some examples include overseas medications and complementary and alternative medications (CAMs).

3. FALSE
Free texting medication can take longer to fill out required fields, as well as much higher rate of errors.

Free text medications are NOT added into the EMR’s in-built warning system (clinical decision support).

There will be no pre-filled administration documentation, interaction and allergy checking.

CHOOSING THE CORRECT FORM FOR SUPPLYING SPECIAL ACCESS SCHEME (SAS) DRUGS

The Therapeutic Goods Administration (TGA) has categorised SAS drugs into three categories, as outlined below:

SAS C: This list, provided and regularly updated by the TGA, specifies drugs listed as category C. These are therapeutic goods with a well-established history of use. It is a notification pathway, and medication can be supplied once the SAS form has been received (IPU might be needed, check formulary restrictions).

SAS A: This category is for individual patients who are seriously ill. It is also a notification pathway, and medication can be supplied once the SAS form has been received (IPU might be needed, check formulary restrictions).

SAS B: If the patient or medication does not fit into categories A or C, this category applies. It is an application pathway, and the prescriber must submit the form to the TGA. The TGA will then provide written approval, which can take up to 10 business days. Medication cannot be supplied until the approval letter is received (IPU might be needed, check formulary restrictions).

If you are unsure about the required form for your patient, please refer to the list of SAS C Medication to see if it is listed there.

If not, it is the responsibility of the prescriber to determine if the patient falls under category A (seriously ill) or category B (other) and complete the appropriate form.

Further information and the forms can be found on the TGA website. Click here to view.

Information on out of stock medications is available on the WH Pharmacy Intranet page and includes WH specific alternatives. Under “Pharmacy Information,” click on “Out of Stock Medications.” For any further
questions about stock issues, see your ward pharmacist or call the pharmacy department at your campus.

 

Have we answered your questions?
Complete our survey or send us an email at med.info@wh.org.au

 

Newsletter contributors: Irina Rigoli (Editor), Namita Warrior, Leanne Nuske, Shani Paiva

 

Links: Links to references are available on the electronic version of the Newsletter. Most links are only accessible through Western Health computer terminals.
Disclaimer: The Western Health Pharmacy Department produces this newsletter to provide Western Health clinical staff with up-to-date information on availability and use of medications and related issues. The Western Health Pharmacy Department has endeavoured to ensure that the content of this newsletter is correct at the time of publication but does not warrant that the information contained in this newsletter is accurate or complete in every respect. In particular, the content of the newsletter is not intended to represent pharmaceutical or health advice. Readers are encouraged to consult other sources to confirm the information contained in this newsletter and/or to obtain further details relevant to their particular clinical circumstances. The information contained in this newsletter is not intended for patient use. Patients should seek professional, expert advice from appropriately qualified and experienced medical staff or other relevant health care professionals.