From: A national survey of inpatient medication systems in English NHS hospitals
Systems and processes | Number of respondent hospitals (% of usable responses) |
---|---|
Prescribing and administration record | ■ Paper versus electronic prescribing system |
87 (87%) used paper drug charts | |
13 (13%) used an EPMA system | |
Medication ordering and supply | ■ Methods used to order medications during pharmacy opening hours†: |
59 (62%) via the ward pharmacy technician (during their ward visit) | |
55 (58%) via the ward pharmacist (during their ward visit) | |
26 (29%) via the ward pharmacist (outside of their ward visit) | |
24 (26%) by taking drug charts to the pharmacy | |
12 (13%) by computer/electronically | |
5 (5%) selected ‘other’: ‘pneumatic tubes’ (n = 2), “pharmacy teams are ward based” (1), “bleeping [paging] the sweep pharmacist [designated to order medication across a range of wards] in the afternoon” (1), “nurse ordering” (1). | |
■ Methods used to obtain medications outside pharmacy opening hours†: | |
97 (97%) borrowed medicines from another ward | |
96 (96%) contacted the on-call pharmacist | |
89 (89%) used a non-electronic reserve drug cupboard | |
39 (39%) borrowed from another patient’s hospital supply (on the same ward) | |
11 (11%) used an electronic reserve drug cupboard | |
9 (9%) selected ‘other’: asked the family to bring in PODs (n = 5), accessed a dispensing robot via the on-call pharmacist (2), medicines were not generally ordered outside of hours (1), 24-hour pharmacy (1). | |
■ Types of medication supply for inpatient administration†: | |
89 (94%) used ward stock | |
85 (89%) used PODs | |
82 (85%) used OSD supplies from the hospital pharmacy | |
46 (50%) used non-OSD supplies from the hospital pharmacy | |
3 (3%) selected ‘other’: all referred to the use of pre-labelled packs | |
Ward-based medication storage and transport during nurses’ drug rounds | ■ Ward-based medication storage† (see also Figure 5 ): |
91 (92%) used patient bedside medication lockers | |
55 (59%) used drug trolleys | |
■ Medication transport during drug rounds†: | |
64 (65%) used drug trolleys | |
31 (43%) used medicines cup/oral syringe | |
10 (14%) used a tray/basket | |
6 (8%) used a temporary trolley (for example, dressing trolley) | |
2 (2%) selected ‘other’: 1 used “PRN lockers per bay”, 1 “drugs cupboard in [each] 6-bedded bay” | |
Medication administration processes, policies and guidance | ■ Regularly scheduled drug rounds (99; 100%) |
■ Availability of policies and guidance: | |
97 (98%) had an ‘out of hours access to medications’ guidance document | |
95 (97%) had guidance document on what to do if a drug was not available | |
90 (93%) had a ‘patient self-administration’ policy | |
80 (92%) had a ‘nil-by-mouth’ policy | |
98 (99%) had an IV guide: 71 (73%) paper-based version, 81 (82%) electronic |