MEDICATION AUDIT &

10 RIGHTS OF
MEDICATION
ADMINISTRATION

(Jan 2018 – Jun 2018)

Anum Hashmi
Pharm D - University of Karachi
Quality Officer – Chiniot General Hospital
LEARNING OBJECTIVES
 What is medication audit, medication errors, its common Causes & its
common Causes ?
 Who will conduct medication audit ? & Why medication audit is
needed?
 Process of medication audit.
 Purpose of medication audit.
 10 Rights of medication administration.
 Statistics of executed audit in CGH.
 Findings of executed audit.
 Requirements of right documentation.
 Avoid the following to ensure right documentation.
 Results.
Medication Audit
Medication Audit Is A Planned Programme,
 Which objectively monitors and evaluates the performance
of all practitioners.

 Which identifies opportunities for improvement,

 Provides mechanisms through which actions

is taken to make and sustain those improvements.

By Definition:
“Medication Audit is a simple tool for
evaluating actual performance and in planning corrective
actions to reduce the risk of medication errors.”
"A medication error is any preventable event that may cause or
lead to inappropriate medication use or patient harm while
the medication is in the control of the health care professional,
patient, or consumer ”.

“The gatekeepers”
Nurses are often the last “gatekeeper” in the administration process to
prevent medication errors.
 What are the Common Causes
for medication errors?

 Transcription.
 Prescription.
 Documentation.
 Not following the medication rights.
 Misuse of zeroes and decimal points.
 Confusing drugs with similar names-Look alike , sound alike names.
 Inappropriate or misinterpreted abbreviations.
 Poor lighting, heat, noise, and interruptions that distract workers from their tasks.
 Staff administering medication when there is a documented allergy (wrong
medication).
 Discontinued, expired or contaminated.
Who will conduct medication
audit ?

 Medication audit is conducted on-site by a

qualified pharmacist, to make sure your staff
manage medicines correctly as determined by
the latest guidance and best practice by.
Why There Is A Need Of Medication
Audit ??

Mac Eachern stated that-

“Financial deficiencies can eventually be met but medical
deficiencies may cost lives and lost of health which can never
be retrieved.”
Process Of Medication Audit:
 The process of medication audit is as follows:
A

C
Reviewing current Reviewing all medication Summarizing the
administration and results in a full audit
stock against medicat
handling procedures
ion record sheets report containing all
ranging from storage,
recommended action
disposal and controlled
points.
drugs to documentation
and recording.
What Is The Purpose Of
Medication Audit?

Patient safety:

First aim in every setting, in order to build

safer systems.

Prevention of medication error:

Checking records and individual supplies of

medication is essential in identifying potential and
actual errors

Close monitoring of medication practices:

So as to reduce patient suffering and ensures

availability of efficient services.
When giving medications

Think…
 10 RIGHTS OF MEDICATION
ADMINISTRATION
• Check the name on the prescription and wristband.
1.Right Patient: • Ideally, use 2 or more identifiers and ask patient to
identify themselves.

• Check the name of the medication, brand names should be

avoided. Check the expiry, Check the prescription.
2.Right Medication: • Make sure medications, especially antibiotics, are reviewed
regularly.

• Check the prescription.

3.Right Dose: • If necessary, calculate the dose and have another nurse
calculate the dose as well.

• Again, check the order and appropriateness of the route

prescribed.
4.Right Dose: • Confirm that the patient can take or receive the medication
by the ordered route.

• Check the frequency of the prescribed medication.

• Double-check that you are giving the prescribed at the
5.Right Time: correct time.
• Confirm when the last dose was given.
 6.Right Patient • Check if the patient understands what the medication is for.
• Make them aware they should contact a healthcare
Education: professional if they experience side-effects or reactions.

• Ensure you have signed for the medication AFTER it has

7.Right been administered.
Documentation: • Ensure the medication is prescribed correctly with a start
and end date if appropriate .

• Ensure you have the patient consent to administer

medications.
8.Right to Refuse: • Be aware that patients do have a right to refuse medication
if they have the capacity to do so.

• Check your patient actually needs the medication.

9.Right Assessment: • Check for contraindications.
• Baseline observations if required.

• Ensure the medication is working the way it should.

10.Right Evaluation: • Ensure medications are reviewed regularly.
• Ongoing observations if required.
 Statistics Of Executed Audit
In CGH
(Jan 2018 - Jun 2018)

Ward Wise
Statics Of Current Audit In
CGH
Jan 2018 – Jun 2018
 COMPARATIVE MEDICATION
AUDIT Analysis of
(Jan 2018 - Jun 2018)
120.00%

97.10% 96.16% 97.45% 96.19% 97.13% 96.96%

100.00%

80.00%

60.00%

40.00%

20.00%

2.90% 3.84% 2.55% 3.81% 2.87% 3.04%

0.00%

January February March April May June

Compliance Non-Compliance
 % COMPLIANCE OF
SURGICAL WARD

120.00%

97.46% 97.04% 98.41% 97.92% 97.79% 98.26%

100.00%

80.00%

60.00%

40.00%

20.00%

2.54% 2.96% 1.59% 2.08% 2.21% 1.74%

0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
SPECIAL WARD
120.00%

97.56% 91.74% 97.64% 98.60% 97.23%

100.00% 95.77%

80.00%

60.00%

40.00%

20.00%

8.26% 4.23%
2.44% 2.36% 1.40% 2.77%
0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
GYNAE WARD

120.00%

98.56% 97.93% 98.33% 98.48% 100.00% 98.23%

100.00%

80.00%

60.00%

40.00%

20.00%

1.44% 2.07% 1.67% 1.52% 0.00% 1.77%

0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
MEDICAL WARD
120.00%

97.71% 97.50% 97.55% 95.11% 98.75% 96.89%

100.00%

80.00%

60.00%

40.00%

20.00%

2.29% 2.50% 2.45% 4.89% 3.11%

1.25%
0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
DELUXE WARD
120.00%

100.00%
95.28% 92.99% 92.59% 96.25%
90.00% 92.86%

80.00%

60.00%

40.00%

20.00%
10.00%
7.01% 7.14% 7.41%
4.72% 3.75%
0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
PEADIATRIC WARD
120.00%

100.00% 96.62% 98.17%

100.00% 97.25%
89.60% 94.00%

80.00%

60.00%

40.00%

20.00%
10.40%
6.00%
0.00% 3.38% 1.83% 2.75%
0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
INTENSIVE CARE UNIT

100.00%
95.00%
89.74% 91.89% 88.14% 89.19% 89.74%
90.00%

80.00%

70.00%

60.00%

50.00%

40.00%

30.00%

20.00%
10.26% 11.86% 10.81% 10.26%
10.00%
8.11%
5.00%
0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
NEONATAL INTENSIVE CARE UNIT

120.00%

100.00% 100.00% 100.00% 100.00% 100.00% 100.00%

100.00%

80.00%

60.00%

40.00%

20.00%

0.00% 0.00% 0.00% 0.00% 0.00% 0.00%

0.00%
January February March April May June
Compliance Non-Compliance
 % COMPLIANCE OF
PEADIATRIC INTENSIVE CARE UNIT

120.00%

100.00% 100.00% 100.00% 100.00% 100.00%

100.00% 93.33%

80.00%

60.00%

40.00%

20.00%

6.67%
0.00% 0.00% 0.00% 0.00% 0.00%
0.00%
January February March April May June
Compliance Non-Compliance
 COMPARATIVE ANALYSIS

Department January February March April May June Average

SURGICAL 97.46% 97.04% 98.41% 97.92% 97.79% 98.26% 97.81%

SPECIAL 97.56% 91.74% 97.64% 95.77% 98.60% 97.23% 96.42%

GYNAE 98.56% 97.93% 98.33% 98.48% 100.00% 98.23% 98.58%

MEDICAL 97.71% 97.50% 97.55% 95.11% 98.75% 96.89% 97.25%

DELUXE 90.00% 95.28% 92.99% 92.86% 92.59% 96.25% 93.33%

PEADS 100% 96.62% 98.17% 97.25% 89.60% 94.00% 95.94%

ICU 89.74% 95.00% 91.89% 88.14% 89.19% 89.74% 90.61%

NICU 100% 100% 100% 100% 100% 100% 100.00%
PICU 100% 100% 100% 100% 100% 93.33% 98.88%
Findings Of Executed Audit.
WHAT ARE THE REQUIREMENTS OF
RIGHT DOCUMENTATION?

BED NUMBER
DATE
TIME
SIGNATURE BY STAFF
Avoid the following to ensure
right documentation.
On vials:
I. Use marker for documenting vials.
II. Avoid documenting with pen.
III. If markers are not available use
sticking tape.
IV. Avoid over writing.
V. Do not retain broken ampules in
patient bed side basket.
VI. Only retain the vials for 24 hours in
patient's bedside basket.
VII. Discard all the retained vials at 12:30
O’clock.
On MAR (Medication administration
record).
I. Check name, MR# and date of
birth of patient before
administering and
documenting any medication.
II. Do not sign the MAR before
administering medication.
III. Avoid over writing or using
correction pen or white paint
pen on the MAR.
Results??
 Top Position Holders for
Jan 2018 – Jun 2018
are……

Best performance
1st position NICU

2ND position PICU 100%

3rd position Gynae ward 98.88%  Staff Seraphine(incharge)

 Faith
Surgical ward 98.58%  Staff Farhina(incharge)  Beenish
 Shehwar  Hammmad
97.58%  Staff Marium (incharge)  Sunya  Haider
 Mona Almas  Rukhsana  Sumaira
 Staff Kamran (incharge)  Mona Liza
 Aneeba  Amber
 Rehmat  Rahat
 Zubair  Asma
 Nabeel  Daboora
 Dildar
 Shumaila
 Saba
Other pOsitiOns …

 4th Medical ward (97.25%)

 5th Special ward (96.42%)
 6th Peads ward (95.94%)
 7th Deluxe ward (93.33%)
 8th ICU (90.61%)
Thank you!