Assessment of Adherence to the Practice Guideline of High Alert Drugs for Inpatient Department: Case Study at a Community Hospital in Central Region

Abstract

High alert drugs (HAD) management is an important safety policy that has been announced by the World Health Organization. In Thailand, the Healthcare Accreditation Institute has provided HAD management as an important standard. This study aimed to assess the adherence to practice guideline and management of drug related problem in HAD group. Methodology: This study was a prospective descriptive observational study. The sample population were 250 prescribing of 10 items of injectable formulation in the high alert drug for inpatient during May 2016 and September 2016. Results: There were 250 prescribing of HADs. There were 80 patients in the study. 51.25 % were men. The mean age was 56.5 years (±19). The most commonly prescribed drugs were 50% magnesium sulfate (50.4%), followed by potassium chloride (20.8%) and dopamine (10.4%). Adherence rates to practice guideline in prescribing, transcribing, dispensing and administrating were 90.3, 99.2, 92.4 and 60.1%, respectively. The activities in each step with adherence rate less than 80 percent included attaching of drug trip card on the medical record (75.6%), writing of order to monitor parameters (72.4%), attaching HAD monitoring record form and recording data in the medical record (71.2%), independent double check before administration (55.2%) and HAD monitoring record form and recording complete data (16.4%). Probable adverse drug reactions from HADs occurred 4 events (1.6%), with amiodarone 1.2% and dopamine 0.4% Conclusion: Adherence rates to practice guideline of HAD in step of prescribing, transcribing and dispensing were 90%. These rates were higher than that in the step of administration (60%). Therefore, there should be measures or incentives to follow the guidelines to prevent harms that may occur to the patient.