Prepared by Elaine Chan & Christopher Chircop Clinical Lead Pharmacists
Western Sydney Local Health District Jan 2019
PHARMACY SERVICES: Helping you look after your
patients
How safe are we in prescribing?
~ 600 medication incidents prevented per month
Top 10 medications for prescribing errors • Oxycodone
• Enoxaparin / heparin
• Amoxycillin/Clavulanate
• Fluticasone/Salmeterol Inhalers
• Sulfamethoxazole/trimethoprim
• Insulins
• Paracetamol
• Metformin
• Colecalciferol
Strategies for improving medication safety in the Australian healthcare setting
Systems to improve: Medicine administration and dispensing Prescribing (e.g. standardising practices,
electronic prescribing) Multidisciplinary care Pharmacy services
System-based approaches to understanding and preventing medication errors
• Australian Commission on Safety and Quality in Health Care (2013), Literature Review: Medication Safety in Australia. ACSQHC, Sydney.
High Risk Medicines (APINCH) • Antimicrobials or anti-infectives
• Potassium and other electrolytes
• Insulins
• Narcotics
• Chemotherapy
• Heparin and other anticoagulants
Inpatient Pharmacy Extension: 57324 Mon-Fri 08:20 – 18:00; Sat-Sun 08:20 – 13:30; After hours on call service via switch
Medicines Information Unit Extension: 56619 Mon-Fri 08:30 - 17:00
Sterile and Non-Sterile Manufacturing Extension: 55070 Mon-Fri 08:20 - 17:20
Outpatient Pharmacy & Clinical Trials Extension: 56542 Mon-Fri 09:00 – 17:00
Cancer Care Pharmacy Service Extension: 57348
Mon-Fri: 08:20-17:20
Hospital in the Home Pharmacists
Antimicrobial Stewardship Pharmacists
How can Pharmacy Help You?
• Provide medicines information
• Assist with therapeutic drug monitoring
• Clinical medication review and reconciliation
• Patient counselling, discharge liaison
• Anything to do with medications!
How do I get help from Pharmacy?
• Contact ward pharmacist directly Via Ward Pharmacist pager
• Call Inpatient Dispensary, Medicines information or Satellite pharmacies
Via switch or check phone numbers on the ward
How can you help us?
• Complete Medication Reconciliation and Medication Management Plans (MMP) for every patient
• Ask for help - avoid guessing or assuming if you are unsure of something
• Listen to us – we are trying to help as part of the multidisciplinary team
• Keep us informed - tell us when important changes to medications occur and when patients are being discharged so we can help as soon as possible
OTHER PHARMACY INFORMATION
Local Health District Drug Committee
• Promotes safe, appropriate and cost-effective use of drugs • Oversees the hospital formulary
• Screening of clinical trials for safety and quality
• Review of Medication incidents
• Review and update of medication related policies and guidelines
Drug Committee-approved documents
Drug Use Protocols, Policies and Guidelines, including: • Anticoagulation
• Antibiotics Aminoglycoside Vancomycin Sepsis
• Safe Use of Potassium Chloride
WSLHD intranet website: http://wslhdintranet.wsahs.nsw.gov.au
Hospital Formulary • List of medications approved for use within the hospital
• Generic drug list, not brand specific except if there are bioequivalence
issues.
• Brands stocked are determined by State Govt. contract/availability
• Approved by WSLHD Drug Committee based on safety, efficacy and cost
• Restrictions may apply - by prescriber, indication or by treatment protocol.
• Objective is to allow for safe and effective drug treatment
• Restrictions may also apply for high cost drugs.
• Require justification for use.
Hospital Formulary
• Search “Formulary” on the intranet
• Available on the intranet - http://wslhdintranet.wsahs.nsw.gov.au/Pharmacy-Directorate/WSLHD-Drug-Committee/Formulary/WSLHD-Formulary
• Generic drug list including restrictions
• Approved by the WSLHD Drug Committee
Non-formulary Medications
• Safety/cost aspects have not been reviewed by the WSLHD drug committee or a formulary application has not been made.
• Non-formulary medications may only be initiated in the hospital with approval from the WSLHD drug committee. • Two members of drug committee need to be
contacted for a telephone approval. • Patients admitted on a non-formulary medication may
continue on the medication without prior drug committee approval
Special Access Scheme (SAS) Medications
• Not marketed or registered in Australia. • Special requirements from the Therapeutic Goods
Administration (TGA) need to be fulfilled for its importation. • Category A or B or C form required
• Patient consent form is required for medico legal cover • Can be completed by a resident but preferrably the
registrar or consultant
• Patient requiring ongoing supplies often need to obtain the medication through our outpatient pharmacy • SAS medication is not a part of the PBS
Safe Use of Medicines Committee
• Reviews medication incidents and develops prevention strategies
• Oversees the development and implementation of medication safety policies and practices
• Includes Junior Medical Officers for input in the practical aspects of implementation
Hospital Outpatient Prescription Used to prescribe: • Highly Specialised Drugs (also
known as Section 100 drugs) • If you do not have a
prescriber number-cannot prescribe on PBS
• Medications that are not covered by the Pharmaceutical Benefits Scheme (PBS) but are essential to the patient’s treatment • Special Access Scheme
(SAS) medications
Hospital PBS prescriptions • S8 and S4D medications such
as benzodiazepines and opioids cannot be prescribed on this prescription
• If you do not have a prescriber
number you cannot prescribe on PBS program
• Prescriber number stays with you at all times
• Provider number (usually for procedures etc.) is dependent on the facility of practice and is not related to prescribing