Safe Dispensing

A system of safe dispensing is very important. The doctor should be in charge of the system and be able to supervise all clinic staff to adhere to the system. The system should be updated regularly and the importance of adherence be monitered and stressed regularly. The following serves to provide some general guidance and each user should review his own system according to individual setting with his staff.

Checking

• Number of types of medication
• type (make sure all parties can recognise each medication. If in doubt, open a new bottle for confirmation, or contact the drug company.)
• dosage (how many tabs each time? How much syrup each time?)
• frequency of dosing
• number of tablets/volume of syrup in each pack
• name of patient
• drug allergy
• checked by the one who prepared the medications, then by the doctor, and then by the one who give the medications to the patient
  

Medication

• check medication by doctor after receiving from drug company
• supervise and check by another person when changing from large container to smaller container
• write the name of the medication clearly on all containers
• make sure that the labels/lids/covers of the containers will not be mixed up, and check this regularly
• do not give fancy names or similar names to medication
• make sure assistants know both the generic and brand name of each medication, and provide a list where they can confirm
• do not order medications which look too similar
• use more individually packed medications
• before pre-packing, have another person to check the medication from the large container, make sure that each pack is clearly and correctly labelled. Containers of pre-packed medications should be labelled clearly.
• Do not put medications which look similar together
• Shelf long term medications (especially dangerous ones: DM, HT, psychotrophic, NSAID) separate with short term medications
• Attach tags to containers of medications which are used in daily or BD dosage instead of more frequent dosing

Doctor

• Leader of the team, must understand the importance of risk management and be able to carry out routine strictly
• Stress the importance of adhering to the system regularly to staff
• Write clearly, do not use abbreviatons difficult to understand or easily confused
• Give enough time for assistants to carry out the checking
• Check system regularly: stock, containers, labels, lids, pre-packed medications….

Clinic assistants

• Understand the importance of adhering strictly to the system
• Give feedback to doctor if encounter occasion where there is a chance of mixing up
• Ask and check if in doubt, and be encouraged to do so
• Report immediately if anything go wrong

The system

• Review according to individual setting with own staff
• Update regularly
• Reiterate the importance regularly
• Peer review