Assessment of Adherence to the Practice Guideline of High Alert Drug (HAD) of Subyai Hospital

Abstract

Introduction: High alert drug management is an important drug safety policy announced by the World Health Organization. It has been established as an important criterion for hospital quality assurance by the Hospital Development and Accreditation Institute of Thailand. 

Objective: This study aimed to evaluate the effectiveness of high alert drug practice guideline and identify high alert drug problems.

Methodology: This study was a retrospective descriptive study for patients whom visited Subyai Hospital during January – December 2021 and received high alert drugs. Data were analyzed using descriptive statistics. Frequency and percentage were presented.

Results: There were 82 prescribing of HADs. There were 82 patients in the study. 60.98 % were men. The mean age was 56.34 years (±18.21). The majority of the patients had no underlying disease (58.54 percent) and 82.93 percent of the patients had improved health at the time of discharge. The most commonly prescribed drugs were potassium chloride injection (52.44 %), followed by amiodarone injection (13.41 %) and adenosine injection (12.20 %). Adherence rates to practice guideline in prescribing, transcribing, dispensing and administrating were 66.67, 96.34, 96.34 and 49.39%, respectively. The activities in each step with adherence rate less than 80 percent included independent double check before administration (73.71 %), writing of order to monitor parameters (54.88 %), prescription is under drug policy (47.56 %), attaching of drug trip card on the medical record, attaching HAD monitoring record form and recording data in the medical record, and HAD monitoring record form and recording complete data (41.46%). Probable adverse drug reactions from HADs occurred six events, with amiodarone injection 3.66 %, nicardipine injection 2.44 % and dopamine injection 1.22 %

Conclusion: The action in the steps of transcribing and dispensing is high, but the steps of prescribing and drug administration procedures are less. Therefore, there should be measured or encouraged to follow the guidelines to prevent harms that may occur to the patients.