Hospitals & Services
Most patients admitted to intensive care will have had medications prescribed for concurrent or pre-morbid conditions. A new drug chart must be started on each patient's arrival in intensive care. Re-charting of all drugs implies an active review of the appropriateness of drug administration and dosage, in changing clinical conditions.
It is important that drug charts are accurate, legal and legible. Similarly only drugs which are approved by intensive care medical staff may be given to intensive care patients. For this reason only intensive care medical staff may write (prescribe) in the patient's drug chart while the patient is in intensive care.
Charting of drugs by outside teams is not permitted.
On discharge to the ward it is the responsibility of the discharging registrar to review patient drug and fluid orders.
In general the following principles should be considered when prescribing any drugs for intensive care patients.
Departmental protocols and guidelines should be used where these exist for a given drug.
Intensive care patients often have vastly altered drug pharmocokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body). Assistance is available from the Clinical Pharmacist.
Good drug prescribing practice is mandatory, including: Legible hand writing, use of generic (not trade) names for drugs, clear delineation of dose, frequency and duration of treatment, printed name and signature.