Ehara tāku toa i te toa takitahi;
engari he toa takitini.
My successes are not mine alone; they are ours.
The greatest successes we will have are from working together.
And with that thought, tēnā koutou,
and welcome to this introduction
to the revised edition of the National Medication Chart.
The Commission commenced a utility review
of the National Medication Chart suite in 2019.
The previous review was completed in 2014,
with an amendment to the oxygen prescribing section in 2016.
Regular review means that the chart design continues to evolve
to meet the needs of current practice.
The medication charts are used in inpatient settings
to record the medicines prescribed and administered
to a patient, along with any allergies
and adverse reactions from medicines.
The Commission supports a suite
of five National Medication Charts -
day stay chart;
eight-day chart;
eight day chart, scannable version;
16-day chart;
16-day chart, scannable version.
Why do we have a National Medication Chart?
The suite of National Medication Charts,
hereinafter referred to as NMC,
were introduced to reduce medication errors
and improve patient safety
through the standardisation of paper-based medication charts
used in Aotearoa hospitals.
The design of the NMC
was the result of an eight-year development phase
involving many health professionals.
The charts are supported by a user guide
and medication charting standard.
The NMCs are extensively used across the sector,
in all DHB hospitals and in some hospices and private hospitals.
The Commission's preference
is for electronic prescribing systems.
For the review of the NMC,
an interdisciplinary committee was established.
The purpose of this committee was to undertake a review
of the utility of the NMC suite
as part of the three-yearly review process.
We would like to thank the NMC Committee
for their active participation in the development
of the revised suite of charts.
NMC users were invited to provide feedback
on the utility of the existing suite of charts.
We received 98 responses
from both DHB hospitals and non-DHB users.
All initial feedback was considered by the NMC committee,
and a revised eight-day chart with proposed changes
was drafted and circulated in October 2019
for further feedback.
Following further submissions,
the recommended and approved changes to the eight-day chart
were finalised, and the full NMC suite was redesigned
to reflect these changes and align with the eight-day chart.
Implementation was due to begin in late 2019.
However, extra time was needed for feedback and consideration,
and then the impact of COVID-19 delayed this further.
It was also necessary to seek clarification
for the oxygen prescribing section,
and this again affected the timing of implementation.
Following consultation with Dr Alex Psirides,
Dr Alan Davis, Dr Iwona Stolarek
and the wider committee, this issue has now been resolved.
This presentation provides a summary of the main changes
to the eight-day NMC.
Where possible, each slide shows an example image
and refers to the page or pages of the chart that are affected.
For further details, please refer to the NMC user guide,
which has been updated to reflect the changes
to support the implementation phase.
This is available on the Commission's website.
ID label panel, page 1.
(READS)
Special care required, page 1.
(READS)
Supplementary charts, page 1.
(READS)
Medicine reconciliation, page 1.
(READS)
Feedback during the review included a recommendation
to have something on the chart itself to highlight that
a medicine reconciliation had been completed.
Sample signatures and initials, page 1.
(READS)
Allergies and adverse reactions, page 2.
(READS)
Verbal orders, page 3.
(READS)
Oxygen therapy and medical gases, page 3.
(READS)
And we have referenced the guidelines
from the Thoracic Society in the user guide.
The dose boxes.
(READS)
The previous inclusion of that instruction
encouraged some prescribers to add a dose range
when a single dose should have been specified.
As required - PRN - medicines,
pages 4 to 7.
(READS)
Recommended administration times, page 15.
(READS)
Non-administration codes,
page 15.
(READS)
Intravenous fluid prescription, page 16.
(READS)
Subcutaneous charting sticker.
(READS)
Kia ora. Thank you for listening to and viewing
this presentation.
The NMC suite is supported by the user guide
and the Medication Charting Standard,
both of which are available on our website.
A PDF version of these slides and commentary
is also available on our website.
Kia whakairia te tapu,
kia wātea ai te ara,
kia turuki whakataha ai,
kia turuki whakataha ai.
Haumi e, hui e,
tāiki e.
Restrictions are moved aside
so the pathway is clear to return to everyday activities,
enriched and unified.