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**Problems and Analysis of Examination Management Regulations for Medical Institutions Handling Narcotic Drugs and Psychotropic Substances**
Based on documents such as the "Management Regulations for Medical Institutions Handling Narcotic Drugs and Psychotropic Substances," evaluations were conducted across various medical institutions. The following issues were identified:
### 2.1 Management Organizations and Responsibilities
In three hospitals, there was insufficient attention paid to the management of special drugs, with a lack of corresponding organizational structures and responsibilities for managing narcotic drugs. Some hospitals failed to conduct training related to the management of narcotic and psychotropic medications.
For example:
- Physicians prescribing narcotic drugs did not fully grasp relevant laws, regulations, policies, and guidelines.
- Prescriptions for hydrochloride pethidine exceeded the allowable daily dosage (e.g., issuing more than 7 days' worth of medication).
- Prescriptions for diazepam lacked proper justification or clinical indications.
### 2.2 Understanding of Laws and Regulations
District hospitals and some physicians responsible for prescribing narcotic drugs demonstrated inadequate knowledge of relevant laws, policies, and regulations. For instance:
- Prescriptions were not always reasonable or strictly adhered to.
- Handwriting was unclear or inconsistent.
- There were instances of overdosing or altered prescriptions.
### 2.3 Format of Narcotic Drug Prescriptions
In five hospitals, the printed format of narcotic drug prescriptions lacked necessary details, such as clinical diagnosis or agent ID numbers. Prescriptions for two types of psychotropic drugs often omitted the required label "Type II" in the upper right corner. Common issues included:
- Missing patient ID numbers or agent ID card numbers.
- Drug names not written according to their generic forms.
- Instances of overdose or altered prescriptions.
- Non-standard usage instructions or illegible handwriting.
- Lack of records for the disposal of residual liquids.
Additionally, six hospitals did not specify the daily dosage requirement on narcotic drug prescriptions.
### 2.4 Pharmacy Stock Management
Stock settlement work for narcotic drugs was not consistently implemented across medical institutions. Some hospitals lacked specialized ledgers for tracking narcotic drugs. In certain cases:
- Operating rooms did not maintain detailed records for narcotic drugs.
- Specialized storage areas for anesthetic drugs were missing or inadequately documented.
### 2.5 Hardware Facilities
Some hospitals lacked dedicated safes for storing anesthetic and psychotropic drugs. Anti-theft doors and alarm systems were also absent in these facilities.
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### 3. Discussion
Most medical institutions have shown increased attention from leadership and relevant functional departments regarding the procurement, management, and use of narcotic drugs. Hospitals generally adhere to the following practices:
- Maintaining neat purchase acceptance records.
- Using designated lockers and databases.
- Employing specialized ledgers for tracking drug inventory.
- Registering empty ampoule recovery and destruction processes.
However, issues remain:
- Some hospitals dispense narcotic drugs outside of authorized procedures.
- Anesthetic drugs are not properly returned after use.
The introduction of regulations such as the "Prescription Management Method," "Clinical Guidelines for Anesthetic Drugs," and "Guiding Principles for the Clinical Application of Psychotropic Drugs" has significantly improved the standardization of narcotic drug management. The primary goal is to meet the legitimate medication needs of clinical patients while effectively preventing the abuse of narcotic drugs.
### Promotion of Learning and Compliance
It is essential for all levels of management organizations to ensure that policies and regulations are communicated and implemented at designated positions. Information dissemination within hospitals, districts, colleges, industries, and government websites should be timely and comprehensive. Even smaller hospitals must not relax their standards for drug management due to lower dosages. All hospitals, regardless of size, should adhere to standardized practices for managing anesthetic and psychotropic drugs.
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