STANDARD DRUG ADMINISTRATION SCHEDULES

To support the principle that standard medication ad­ministration times should be based primarily on optimal pharmacotherapeutics and safe medication administration practices, with secondary consideration of workload, caregiver preference, patient preference, and logistical issues; further,

To encourage the development of hospital-specific or health-system-specific standard administration times through an interdisciplinary process coordinated by the pharmacy; further,

To encourage information technology vendors to adopt these principles in system design while allowing flex­ibility to meet site-specific patient needs.

Rationale

Administering medications at the right time is one of the original “five rights” of medication administration. To achieve the best patient outcomes, standard medication ad­ministration times should be based primarily on optimal pharmacotherapeutics and safe medication administration practices. Standard drug administration times help prevent over- or under-dosing of patient medications, improve communication between disciplines, and reduce workload and potential for errors. For example, appropriate timing of laboratory blood draws and other bedside monitoring is critical for obtaining accurate patient data, and standard administration times decrease the chance for miscommunication.

Although considerations such as workload, caregiver and patient preference, and logistical issues cannot be ignored, they should be only secondary considerations in the interprofessional development of hospital- or health-system-specific standard administration times, a process best coordinated by the pharmacy, as medication-use experts. Healthcare systems should establish interdisciplinary policies and procedures related to standard drug administration times for all practitioners responsible for administering medications. Such policies can help concentrate staffing, optimize workflows, and mitigate potential medication safety gaps.

To promote adoption and avoid dangerous work-arounds, standardization of drug administration times and pertinent monitoring times should be built into workflows to the extent possible. Healthcare information technology vendors should design these systems to optimize the safety and operational aspects of the medication-use process while allowing for necessary site-specific individualization.