To utilize appropriate medication charts (e.g. National Standard Medication Chart {NSMC}, Intravenous orders chart, clozapine chart) to promote safe prescribing, dispensing and administration of medications to patients.

To utilize appropriate medication charts (e.g. National Standard Medication Chart {NSMC}, Intravenous orders chart, clozapine chart) to promote safe prescribing, dispensing and administration of medications to patients.

ACSQHC: Australian Commission on Safety and Quality in Healthcare.

Clinicians: Persons involved in the medication management pathway.

Dispensing: The process of preparing and issuing drugs or drug mixtures from a pharmaceutical outlet or department

Medication Chart: Medication chart approved by GH-B to prescribe, administer or dispense medications from (e.g. clozapine chart, National inpatient adult subcutaneous insulin chart).

NSMC (National Standard Medication Chart): refers to Medication Chart MR/700.2, Long Term Medication Chart MR/715.2 and MR/715.1, Paediatric Medication Chart MR/700.5.

Nurse: in this document refers to an Registered Nurse, Registered Midwife or Enrolled Nurse.

Prescriber: Any registered health professional who are endorsed to prescribe by their associated Board.

• All admitted patients (including ED patients) requiring the administration of medications will have a medication chart established. The only approved exception is GH at Home surgical stream patients who have been transferred from an inpatient ward (GH-B or other hospital) AND have a complete and current list of their medicines documented on discharge/transfer from that ward AND no medicines are prescribed by GH at Home medical staff or changes made to medicines.

• This chart will be the National Standard Medication Chart (NSMC) in its various formats as developed or other appropriate GH approved medication chart.

• All medication charts will have patient identification stickers applied in the designated areas as well as the patient's name printed in the designated places.

• If no patient identification label is available then the minimum details acceptable, to be legibly printed on the chart, are: patient name, UR number and date of birth (as per Patient Identification and Procedure Matching POL0036).

• All medication charts will have the allergies and adverse reactions box completed (as per Adverse Drug Reactions (including Allergies) - Recording And Reporting - CPP0573) and have two stickers identifying the patients Adverse Drug Reaction (ADR) status . This will follow the traffic light system. 

• CPP0286 -Medication Orders will be adhered to when using the medication chart.

• Medication charts will only be used for their designated period, (eg. Acute chart seven days). A new NSMC must be written after this time period.

 PRESCRIBING

Refer to Appendix 1: "Legal Requirements of Completing a Prescription (including PBS prescriptions)."

DISPENSING

• Dispensing may only be untaken by authorised staff (medical practitioners or pharmacists) Registered Nurses are not authorised to dispense medications to patients.

• Patient's Own Medications may be used as per Medications - Use Of Patient's Own - CPP0095.

• Medications which are not available through the use of Patient's Own Medications and are not on ward imprest should be requested from Pharmacy.

• Before ordering, all charts must be checked to ensure all sections are appropriately completed. Pharmacy will NOT dispense any medication if the medication order, patient details or allergy adverse reactions sections, are incomplete (in this setting incomplete being defined as no information recorded in allergy box). The Pharmacy will not supply a medication to which a patient has a documented allergy to unless a trial of the medication is documented in the progress notes as per CPP0573 Adverse Drug Reactions (including Allergies)- Recording and Reporting

• To order medications from pharmacy, the date box at the side of the order needs to be completed. For once only, premedications and telephone orders astrix (*) the required medication.

• For wards where there is a clinical pharmacy service, the unit pharmacist should be paged to alert them to the request. A copy of the chart is left in the designated location.

• For wards without a clinical pharmacy service, the request may be faxed to pharmacy. All pages of the current medication chart/s need to be faxed down.

• Any sections of the medication chart designated for pharmacy use will used by pharmacy staff to clarify orders with relevant annotations. Pharmacy will add any notations in purple pen.

• Pharmacy will not supply a medication without a valid and legal order/script/medication chart from an appropiate prescriber. 

• Pharmacy will utilise barcode scanning (where possible) to reduce the risk of dispensing errors.

• All information provided to Medicare Australia will be clear and not false/misleading/ or by means of impersonation.

ADMINISTRATION

Legal Requirements for Administration Include: (as per Poisons and Controlled Substances Regulations 2017 (Vic) Regulations: 92, 40A, 133, 96):

1) Medicines may only be administered for the treatment of patients under GH-B care, and not to the nurse themselves.

2) The nurse must be confident that a therapeutic needs exists, and this does not include for the purpose of supporting the drug dependence of a person.

3) An authorised registered nurse or and approved registered midwife must not sell, supply or administer a Schedule 2, 3, 4 or 8 poison unless:

• that poison is for the treatment of a person under the nurse's care; and

• if the poison is a drug of dependence, the nurse has taken all reasonable steps to ascertain the identity of the person who is to be treated.

4) if the poison is a drug of dependence or a Schedule 8 poison, the nurse shall take all reasonable steps to ascertain the identity of the person for whose treatment the poison is supplied

Refer to Regulation 96 regarding: conditions where a nurse of registered midwife may administer a scheduled poison. (Link to the Regulations is in References section below)