Medication charts are used to record the medicines prescribed and administered to a patient along with any allergies and adverse reactions from medicines. A major initiative aimed at reducing medication errors and improving patient safety has been to standardise the paper-based medication charts used in New Zealand hospitals.
Standardisation in practice is a recognised safety initiative in many industries. Health professionals who prescribe medicines often move between hospitals. The new chart will reduce medication errors that can happen when clinicians are unfamiliar with a chart, or with a hospital’s unique systems.
Another benefit of standardising the medication chart is the increased awareness among health professionals of the possibility of incidents occurring. It is also a necessary step before the introduction of an electronic prescribing and administration system to all New Zealand hospitals.
The design of the national medication chart has been the result of an eight-year development phase involving many health professionals. An electronic change register is available for all hospitals to contribute to future refinements of the chart.
While the chart has been implemented in public hospitals the Commission is committed to expanding the adoption of a chart across the entire sector, including aged care and private hospitals.
Feed back from Capital & Coast DHB has been positive:
"It's really improved legibility."
"Boxes for units are useful....we used to have real issues with mcg/mg/µg."
"Great to finally have a proper O2 section."
Aged Residential Care
Aged Residential Care (ARC) facilities currently use a variety of medication charts when administering medicines to residents. Concerns have been raised by the sector about the diversity of charts in use and the consequent impact this has on resident and staff safety. In April 2012 the Health Quality & Safety Commission initiated a project to develop a standard medication chart for use in ARC facilities that enhances the safe and quality use of medicines. PharmacyPartners Ltd were contracted to deliver this project for the Commission. A final report was delivered in December 2013. The report recommended several changes to the chart design. It also noted that changes to dispensing software were needed to allow generation of a printed chart without individual pharmacists having to configure the design. The Commission agreed that the revised chart should be tested before it could be recommended for use by the sector. One dispensary system has made the necessary software changes so that community pharmacies can generate the printed test chart without having to configure the system in their pharmacy. The chart is being tested in two facilities and the test is being independently evaluated. The Commission fully supports the use of electronic prescribing and administration systems but we are aware it will be some time before all aged residential care facilities are in a position to implement electronic solutions.