Professional Documents
Culture Documents
Medicines Use in Australia
Medicines Use in Australia
Australia
Jane Booth
June 2014
Austin Hospital
- founded 1880
Heidelberg Repatriation
Hospital - founded 1941
Catchment area
Primary catchment area
Banyule and Darebin
Population >260,000 people
(expected to grow by 2.1% by
2016)
Culturally diverse, of Darebin
residents born in a non-English
speaking country
Significant Aboriginal
community
Areas of social disadvantage
2.
8,000 staff
3.
4.
5.
Psychiatry (inc. Child, Adolescent & Adult inpatient units, Secure Extended
Care Unit, Parent & Infant Service, Body Image/Eating Disorders Service,
Psychological Trauma Recovery Service/Veterans Psychiatry, Drug
Dependency Clinic)
Emergency Department
Paediatrics and Paediatric Surgery
Intensive Care Unit, Anaesthetics & Pain Services
General Medicine
Aged Care
Rehabilitation (including Brain Disorders, Acute Brain Injury, Amputee)
Spinal (including Spinal Surgery)
Gastroenterology, Liver Transplant Unit
Infectious Diseases
23 Pharmacy Technicians
10 Pharmacy Store staff
3. Intern pharmacists
7 Intern Pharmacists
2.
Find out who is going home and begin reviewing discharge scripts
3.
Take discharge medications back to the ward and provide bedside counselling
4.
Medication Reconciliation
5.
6.
7.
8.
Standard
Core Actions
Developmental Actions
44
11
39
Medication Safety
31
Clinical Handover
20
20
15
18
209
47
Electronic prescribing
Cerner PowerChart
All orders placed electronically. 100% of orders are
legible
All changes tracked transparently in the system.
Certain fields locked down on Modify
2. Antibiotic Stewardship
To promote appropriate and proper prescribing of
antimicrobials
Antimicrobial Stewardship programs aim to reduce
chance of antimicrobial resistance, toxicity and
unnecessary costs
Multiple methods employed in the eMM context:
Electronic Approval System (*external to Cerner)
Specialised Care Sets and Order sentences including time
offsets and drug level reminder tasks
Alerts
Reports
In Cerner
Creative use of Discern Alert
Cannot proceed with order unless approval number is
documented in appropriate field
4. Allergy Documentation
Having allergy information readily available reduces the risk of
patients having an adverse event
Should be available to all those who prescribe, dispense and
administer medications
Local policy states all patients should have their allergy recorded
and all clinicians are responsible
Electronic medication management systems can warn prescribers
before an order is placed through allergy interaction checking (as
well as drug interactions)
4. Allergy Documentation
4. Allergy Documentation
4. Allergy Documentation
Austin Health - Allergy Audit
% Patients with Allergies Recorded
100,00%
99,00%
98,26%
98,00%
97,04%
97,00%
96,00%
97,44%
97,33%
97,83%
97,19%
97,30%
97,08%
96,80%
96,84%
Feb
Mar
96,28%
96,51%
95,57%
95,00%
94,00%
93,00%
92,00%
91,00%
90,00%
Apr
May
Jun
Jul
Aug
2013
Sep
Oct
Nov
Dec
Jan
2014
Apr
7 meropenem allergies
82 cephalosporin allergies
42 cases of documentation OK to proceed
12 allergies of minor significance (e.g. nausea or
diarrhoea)
24 orders cancelled (i.e. not administered)
Need further investigation
Moving forward
The future: enhancing data capture and interpretation
capabilities
The more information we can get in the more powerful
reporting and auditing becomes
Acknowledgements
Alana Meaklim
Anne McGrath
Adrian Lio