Table 2 Key features of inpatient medication systems used on the majority of medical and surgical wards

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