Contents 1. Introduction 2 4.8 Conditional dosing 27 4.9 Infusions 28 1.1 How to use the Requirements 3 4.10 Antimicrobial medicines 29 2. Requirements for the Australian context 4 4.11 Controlled medicines 29 5. Clinical decision support 30 2.1 State and territory legislation 4 2.2 Australian Government legislation 5 6. Pharmacist review 34 2.3 National infrastructure and standards 6 6.1 Supply and interface with dispensing systems 35 2.4 National Safety and Quality Health Service Standards 8 7. Medication administration 36 3. General EMM requirements 10 7.1 Before administering medicines 36 3.1 EMM principles 10 7.2 Medication administration workflow 37 3.2 Audit, access and synchronisation 11 7.3 Medication administration 40 3.3 Patient identification 11 8. Discharge medicines 42 3.4 Allergies and adverse drug reactions 12 9. Electronic medication 3.5 Continuous medication management 13 information exchange 44 3.6 Medication-related clinical information 14 9.1 Medication safety if there are multiple EMM systems 44 3.7 Medication reconciliation 15 9.2 Support for medication reconciliation 45 3.7.1 General requirements 15 10. Specialty-specific 3.7.2 On entry to the organisation 16 EMM requirements 46 3.7.3 On discharge from the organisation 16 10.1 Chemotherapy 46 3.7.4 Transfer 17 10.2 Paediatrics 48 3.7.5 Safety features of the printed national standard medication chart 17 10.3 Anaesthetics and intensive care units 50 4. Prescribing medicines 18 10.4 Emergency department, including resuscitation 50 4.1 Prescriber workflow 18 10.5 Renal dialysis 51 4.2 General prescribing 20 11. Support for business as usual 52 4.3 Changes to medicine orders 24 Appendix Information sources 53 4.4 PRN medicines 24 References 54 4.5 Medicines with complex instructions 25 4.6 High-risk medicines 25 4.7 Variable-dose medicines 26
Contents 1. Introduction 2 1.1 How to use the Requirements 3 2. Requirements for the Australian context 4 2.1 State and territory legislation 4 2.2 Australian Government legislation 5 2.3 National infrastructure and standards 6 2.4 National Safety and Quality Health Service Standards 8 3. General EMM requirements 10 3.1 EMM principles 10 3.2 Audit, access and synchronisation 11 3.3 Patient identification 11 3.4 Allergies and adverse drug reactions 12 3.5 Continuous medication management 13 3.6 Medication-related clinical information 14 3.7 Medication reconciliation 15 3.7.1 General requirements 15 3.7.2 On entry to the organisation 16 3.7.3 On discharge from the organisation 16 3.7.4 Transfer 17 3.7.5 Safety features of the printed national standard medication chart 17 4. Prescribing medicines 18 4.1 Prescriber workflow 18 4.2 General prescribing 20 4.3 Changes to medicine orders 24 4.4 PRN medicines 24 4.5 Medicines with complex instructions 25 4.6 High-risk medicines 25 4.7 Variable-dose medicines 26 4.8 Conditional dosing 27 4.9 Infusions 28 4.10 Antimicrobial medicines 29 4.11 Controlled medicines 29 5. Clinical decision support 30 6. Pharmacist review 34 6.1 Supply and interface with dispensing systems 35 7. Medication administration 36 7.1 Before administering medicines 36 7.2 Medication administration workflow 37 7.3 Medication administration 40 8. Discharge medicines 42 9. Electronic medication information exchange 44 9.1 Medication safety if there are multiple EMM systems 44 9.2 Support for medication reconciliation 45 10. Specialty-specific EMM requirements 46 10.1 Chemotherapy 46 10.2 Paediatrics 48 10.3 Anaesthetics and intensive care units 50 10.4 Emergency department, including resuscitation 50 10.5 Renal dialysis 51 11. Support for business as usual 52 Appendix Information sources 53 References 54
EMM-Business-Requirements-January-2018.docx