Did you know
All medications given to patients at LHSC are provided by LHSC Pharmacy Services.
As one of Canada’s leaders in progressive hospital pharmacy practice, LHSC has a strong history of innovation and operates under a rigorous process, with checks and balances along each stage of drug delivery to ensure patient safety.
Every day, pharmacy service professionals are working to ensure that the right dose of the right drug is delivered to the right patient at the right time, each and every time a medication is dispensed.
Steps of drug delivery
- Accurate and up-to-date medication history is completed by the medical team, patient and/or family.
- Patient’s condition is reviewed by an interdisciplinary team (e.g., physician, nurse, pharmacist).
- All medications to be administered to a patient require a prescription or doctor’s order.
- Prescriptions are written by physician, sometimes with help of pharmacist based on:
- what drug is best,
- possible drug interactions and/or side effects and,
- medication reconciliation information.
Processing the order
- A nurse enters prescription into the medication administration record (MAR), which is used to document any time a medication is given to the patient.
- A pharmacist comprehensively reviews every medication order before authorizing the technicians to fill the order.
- Technicians enter order into a system, which performs an additional electronic check to ensure no history of allergies to a drug or drug interactions.
Filling and checking the order
- Prescription information is sent to the appropriate pharmacy production area – either to
- Pharmacy robot (PACO). Using bar-code technology, PACO can dispense up to 10,000 doses per day virtually error free.
- Pharmacy technician at a filling station. The technician receives list of medications and picks proper medications and doses manually. These filled orders are reviewed by a second technician. Medications are labeled by patient name, room number, etc.
- Intravenous medication go to a special sterile location called a clean room, which has monitors and controls that ensure the environment is sterile at all times. Technicians perform double checks on each other’s work to ensure order filled properly.
Additional check and delivery
- Medications for patients are dispensed daily (instead of weekly), so the nurse has the most accurate and current medication and dosage available for administration to the patient.
- Porters transport medications, which are labeled in detail with patient’s specific information, to the nursing unit for the nurse to administer.
- Each patient has his or her own personalized bin where their medications for the day are kept.
- Nurse checks the medication against the medication administration record (MAR) to ensure it is the same medication that was called for in the prescription.
Final safety check
- Before administering the medication the nurse must verify 8 rights:
- right PATIENT
- right MEDICATION to be given
- right REASON
- right DOSE
- right ROUTE
- right FREQUENCY
- right TIME/DAY of order
- right SITE