COUNTRY REPORT MALAYSIA - asia4safehandling...COUNTRY REPORT MALAYSIA HARBANS DHILLON UNIVERSITY...
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COUNTRY REPORT MALAYSIA HARBANS DHILLON UNIVERSITY MALAYA MEDICAL CENTRE MALAYSIA APOPC Jakarta 2012
Transcript of COUNTRY REPORT MALAYSIA - asia4safehandling...COUNTRY REPORT MALAYSIA HARBANS DHILLON UNIVERSITY...
COUNTRY REPORT MALAYSIA
HARBANS DHILLON
UNIVERSITY MALAYA MEDICAL CENTRE
MALAYSIA
APOPC Jakarta 2012
APOPC Jakarta 2012
GUIDELINES BY MOH
Pharmaceutical Services Division of MOH Malaysia has guidelines, published March 2010, named “Guides to the Development of Sterile Pharmaceutical Preparation facilities for Healthcare Establishments”
They conduct a once yearly course for pharmacists & pharmacy technicians
PENSMA also conducts yearly courses
APOPC Jakarta 2012
GUIDELINES BY MOH
Table of contents:› Scope & How to use these guidelines› Policies› Design, layout & specifications› Cytotoxic Drug Reconstitution Facility requirements List of equipment required
› PN/IV admixture/eyedrop (Non-CDR)› Management & Document control areas› Storage, receiving & distribution areas
APOPC Jakarta 2012
GUIDELINES BY MOH
Ancillary areas› Appendix 1: example of layout plan for CDR
preparation facilities› Appendix 2: example of layout plan for PN/IV
admixture/eyedrop (non CDR) preparation facilities› Appendix 3: Air locks for personel & materials in
clean rooms› Appendix 4: Examples of types of construction
material for clean rooms› Appendix 5: Recommend filtration levels for
different clean room grades› Appendix 6: Clean room classifications
APOPC Jakarta 2012
IMPORTANT ASPECTS
Technical› Centralized reconstitution of cytotoxic drugs› Trained & skilled personnel
Facilities & Equipment Clinical
› Ward rounds with doctors & nurses› Provide accurate & up to date drug information› Dose adjustments, managing drug toxicities
Training.APOPC Jakarta 2012
ORDERING
Some IT hospitals use Computerised Physician Order Entry (CPOE)
In Putrajaya Hospital, CPOE shown reduction in prescription errors but not dosage regimes (Malaysian Journal of Public Health Medicine, Vol 11 2011)
Mainly done by handwritten prescriptions Some use preprinted protocols with only doses
handwritten Illegible handwriting making it error prone.
APOPC Jakarta 2012
Chemotherapy protocolUMMC Kuala LumpurCA Breast: FEC regime
(label)Name :__________________________DOB :___________________________RN : ____________________________
Diagnosis : ________________ Stage :___Ward :_________ Cycle no : ______Creatinine Clearance :___________
Height :____________cm Weight : _______kg BSA :_______m2
Day 1
Date Start time
Drug Dose Duration of infusion Stop time
Sig
IVB granisetron 3 mg orTab granisetron 2mgIVB Dexamethasone 8 mg
½ h before chemo due
IVB 5FU 500mg/m2
IVI Epirubicin 75mg/m2 in 100ml NS
over 20-30 min
IVB Cyclophosphamide 500mg/m2
Tab Metoclopramide 10mg tds for 3 days
Tab Dexamethasone 2mg tds for 3 days
Prescriber’s signature:_________________________Checked by:________________________________ Screened by pharmacist:_______________________Medications in bold supplied by pharmacy:
Drug Round doses to nearest Expiry
5FU bolus 50 mg 28 days, R, PFL
Epirubicin in 100ml NS 10 mg 28 days, R, PFL
Cyclophosphamide bolus 100 mg 28 days, R, PFL
APOPC Jakarta 2012
APOPC Jakarta 2012
CYTOTOXIC DRUG RECONSTITUTION
APOPC Jakarta 2012
Cleanrooms available in some hospitals BSCs/Isolators are used Mainly isolators are used if no cleanrooms are
available Some hospital pharmacies without cleanrooms
use closed system transfer devices (CSTD) In some hospitals nurses still do reconstitution,
some using CSTD & some not.
BSC/ISOLATORS
APOPC Jakarta 2012
PURCHASE OF CYTOTOXIC DRUGS
APOPC Jakarta 2012
Mainly through tender system Specifications may not include safety
features Cost determines type of cytotoxic drugs
purchased rather than safety features New compounding centre in Petaling Jaya.
GUIDELINES FOR CONTINUOUS PROFESSIONAL DEVELOPMENT (CPD)PROGRAMME FOR MEDICAL OFFICERS AND PHARMACISTS
APOPC Jakarta 2012
CPD Category CPD Activity Description Points per Activity Criteria / Explanatory NotesMaximum Points for
Annual Consideration
A1 Congress/Conference (Local/ international)
20 per conference A conference should:
a. Be conducted not less than 3 full days, a full day being 5-8 hours.
b. Involve speakers of international standing.
c. Contain plenary lectures / symposia.
d. Allow presentation of free communication / poster, etc.
20
A2 Scientific Meetings of Chapters of Academy/ Universities/ Colleges/Association/Institutions/ Ministry of Health & othersa.Less than 2 hours b.2-4 hours (1/2 day)c.5-8 hrs (full day)d.2 full dayse.3 or more full days.
1 point2 points3 points6 points10 points
20
A3 Workshops/ Courses/ Fellowships/ attachment etc. (include hands-on & skills courses)a.Half day (2-4 hours)b.Full day (5-8 hours)c.2 full daysd.3 or more full dayse.Skills accredited structured courses by specific disciplines (e.g. ALS, PALS, NRP, MTLS)f.Study Tour
4 points6 points10 points15 points20 points
5 points
For professional attachment, credit
points are awarded to participants
from outside the place of work,
e.g. Tertiary Hospitals, University
Hospitals.
30
CPD Category CPD Activity Description Points per Activity Criteria / Explanatory NotesMaximum Points for
Annual Consideration
A4CME sessions/ other professionalactivities e.g.Topic seminar, Forum, Lectures, JournalClub, Formal Ward rounds (teachingrounds), Clinic attendance, Hospitalclinical meeting, Video show, Videoconferencing, Reflective Notes, Morbidityand mortality reviews, Epidemiologicalreviews
1 point/ hourFor ward rounds credit points are
awarded to participants from
outside own hospital/
establishment, e.g. Private
practitioners, verified by the CPD
Chairman of that institution.
20
A5Presentation at accredited meeting- Plenary lecture/long paper (>45 min.) / Free paper / short paper- Others lectures/ talks e.g. Visiting lecture, Hospital clinical meeting, CME sessions, Public meeting, Giving talk /public advice, Lectures to NGO/ radio or TV talk, Technical briefing/ update.
10 points5 points
These credit points are in addition
to full delegate attendance at
congresses, scientific meetings or
workshops. Otherwise only credit
points for presentation are
attainable.
Visiting lecture – Where one is
officially invited to give a lecture at
venue/ function away from one’s
principal place of practice.
20
CPD Category CPD Activity Description Points per Activity Criteria / Explanatory NotesMaximum Points for
Annual Consideration
A6Publication of articles in journal/
chapters in book /reportsa.Indexed/ Peer reviewed Journal (authors) b.Non-indexed journal (authors)c.Chapter in book - each chapterd.Reports e.g. Technical report, working papers,etc.
20 points10 points10 points10 points
An indexed journal is one which
has international standing and is
listed in the Index Medicus or
similar indexing system.Maximum for writing chapters in a book is 20.
30
A7Self-study/ Group study/ Distance
learning e.g.Reading scientific papers from indexed journals, Audio-visual, Organized group discussion under accredited co-coordinator
1 point/paper orsession
Documented evidence (with
verification) needs to be produced
e.g:a)Self study – Self administered MCQb)Documented evidence in the form of synopsis/ evidence tableEach individual is personally responsible to source for and read relevant PTK materials.
20
CPD Category CPD Activity Description Points per Activity Criteria / Explanatory NotesMaximum Points for
Annual Consideration
A8 CME Online 1 point/article or sessionThe CPD Board is ultimatelyresponsible for accreditation ofthe providers.
20
A9 Post-basic coursesa.1-2 weeksb.2-4 weeksc.>1-3 monthsd.>3-6 monthse.>6 months – 1 yr
10 points12 points15 points20 points30 points
These should be:a.Conducted by relevant recognized authorities - local or internationalb.Verified by the CPD committeec.Points are given only once, upon completion of studies.
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A10 a. Degree, Masters Programs, Postgraduate programmes (for each stage of examination passed)
b. PhD/DrPHc. Advanced Diploma/Subspecialty
training
50 points50 points50 points
Allowed to also get points from other categories / sections 50
A11 Involvement as committee or projectmembera.Quality Initiatives eg. KMK, Innovations, TQM, Accreditation, ISO, etcb.Research projects (as researcher/ collaborator)c.Training activities (as facilitator/ trainer)
5 points for involvement in each area
20
CPD Category CPD Activity Description Points per Activity Criteria / Explanatory NotesMaximum Points for
Annual Consideration
B1 EditorMember of Editorial BoardReferee/ reviewer (per article)
10 points5 points5 points
Pertaining to production of journals, special reports, bulletins, newsletters etc.
10
B2 Other supporting activities related to personal development and self-improvement:Leadership, Management, IT, Organizing Committee/Secretariat, Innovation, Arts, music,Languages, Teamwork, Member of professional body, etca.Local levelb.State levelc.National leveld.International level
2 points /activity3 points /activity5 points /activity10 points /activity
These activities are not restricted to MOH functions e.g. involvement in PIBG may also be considered.Documented evidence (with verification) needs to be produced)
10
B3 Registered Members attending Professional Society Annual General Meeting
2 points Note ; For Pharmacists OnlyA valid membership registration & proof of attendance must be provided and verified
2
List of universities with Provisional Accreditation from the Malaysian Qualifications Agency (MQA)
No. Institution Programme
1. Universiti Sains Malaysia Sarjana Muda Farmasi (kepujian)*
2. Universiti Kebangsaan Malaysia Sarjana Muda Farmasi (kepujian)*
3. Universiti Malaya Sarjana Muda Farmasi (kepujian)*
4. Universiti Teknologi MARA Sarjana Muda Farmasi (kepujian)*
5. Universiti Islam Antarabangsa Malaysia(UIAM)
Bachelor of Pharmacy (Hons)*
6. UCSI University Bachelor of Pharmacy (Hons)*
7. International Medical University (IMU) Master of Pharmacy (twining 2 ½ + 1with University Strathclyde, UK)Master of Pharmacy (twining 2 + 2 withUniversity Strathclyde, UK)Bachelor of Pharmacy (Hons)*
8. AIMST University Bachelor of Pharmacy (Hons)*
9. University Nottingham MalaysiaCampus (UNMC)
Master in Pharmacy 2+2 similar *programme of University Nottingham,UK
No. Institution Programme
10. Cyberjaya University College of MedicalSciences (CUCMS)
Bachelor of Pharmacy (Hons)*
11. Masterskill University College of HealthSciences (MUCH)
Bachelor of Pharmacy (Hons)4+0 with University La Trope, Australia
12. Management & Science University (MSU) Bachelor of Pharmacy (Hons)
13. SEGI University College Master of Pharmacy 2+2 twinning withUniversity of Sunderland, UK
14. Monash University Malaysia Campus Bachelor of Pharmacy (Hons) similarprogramme of Monash University,Australia
15. Malaysian Allied Health SciencesAcademy (MAHSA)
Master of Pharmacy (twining 2+2 withUniversity of John Moores, UK)Bachelor of Pharmacy (Hons)
16. Help International College of Technology(HICT)
Bachelor of Pharmacy (Hons)4+0 with USM as franchisedprogramme
17. Taylor’s University Bachelor of Pharmacy (Hons)
Master of Pharmacy (2+2) incollaboration with Cardiff University,UK
IMPROVED CAREER PATHWAY
In 2010, PM implemented an improved career pathway for MOs, dentists & pharmacists in MOH
To improve the level of health services efficiently & effectively to the people
Based on a set career path plan, the maximum amount of time for officers eligible for promotion to be promoted to Grade 54 from the date of service as follows:
Medical Officer (Specialist): 9 years Dental Officer (Specialist): 9 years Medical Officer (Clinical / Administration): 12 years Dental Officer (Clinical / Administration): 12 years Pharmacist: 14 years
CAREER PATHWAY SUMMARY
Pharmacist Duration
Gred 41 – Gred 44 3 years in Gred 41
Gred 44 – Gred 484 years in Gred 44 or subject to
vacancywhich ever comes first
Gred 48 – Gred 524 years in Gred 48 or subject to
vacancywhich ever comes first
Gred 52 – Gred 54 3 years in Gred 52 or subject to vacancy
which ever comes first
Gred 54 to Special ‘C’ and above subject to vacancy availability
Overall period to achieve Gred 54 from date of appointment 14 years
CHALLENGES Individual hospitals maintain their own standards No national standard, only guidelines Maintenance of cleanrooms & equipment Safety measures not fully implemented for
pharmacy & esp. for administration by nurses Laundry, waste disposal & patient excreta Errors still occur with chemo Managing rising costs of cytotoxic drugs & products
related to reconstitution (CSTD) Difficulty in recruiting oncology pharmacists &
keeping trained staffAPOPC Jakarta 2012
CYTOCARE®Weight: 1450kgDimensions: 2.1m x 1.6m x 2.3m Power: 500V (±) Exhaust outlet required
i.v.STATION® ONCOWeight: 410kgDimensions: 1m x 1.5m x 2.3mPower: 110/230V (±)Exhaust outlet: Required
