<Insert Trust logo here>
Procedure number:
UKMI-07
Procedure title:
Documenting enquiries using MiDatabank
Background
The UKMi website contains a list of medicines information work that should be documented as an
enquiry (http://www.ukmi.nhs.uk/Policy_product/cgEnquiriesToDoc.asp). Complete documentation is an
essential part of the enquiry answering process and is an audit standard. Complete documentation also
allows collation of correct statistical information relating to enquiry answering.
See also Guidelines for Quality in Enquiry Answering at
http://www.ukmi.nhs.uk/Policy_product/cg_enq_answering.asp
MiDatabank is a paperless enquiry recording database. It provides prompts to enter appropriate
documentation and users are frequently unable to proceed until this is completed. This procedure
augments these prompts and provides further detail to ensure complete, accurate documentation. In
addition, it incorporates much of the information in the above guidelines; however it does not replace
training and assessment of competence in the use of MiDatabank. Further information and support
material relating to MiDatabank can be found at: www.midatabank.com. The FAQ section is particularly
helpful.
Objective/ aim of procedure
To ensure full and complete documentation is achieved for all enquiries received.
Risk Management Notes
Clear and comprehensive documentation is necessary for legal and ethical reasons, in order to ascertain
exactly what information was provided, how it was interpreted, by whom and what resources were used.
Appropriate documentation ensures that an enquiry can be located at a later date, to save time in
dealing with future enquiries.
Procedure
1. Good Practice Points
1.1. Keep your documentation about individual enquiries on MiDatabank up to date. It is best
practice to log your research and summarise your answer before contacting the enquirer with
an answer, as writing up retrospectively can lead to errors.
1.2. Ensure that documentation is clear and that what you have written makes sense. Check your
spelling and punctuation as appropriate.
1.3. Use only accepted clinical abbreviations.
1.4. ‘Sign’ every entry you make by using Ctrl+M, for audit purposes.
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
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(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
(Signed)
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1.5. Open the relevant enquiry screen or ensure the timer is on when you are working on a
particular enquiry (including letter checking time). You need to allocate the enquiry to yourself in
order for the timer to switch on.
1.6. Turn the timer off or close the screen when not working on a particular enquiry.
1.7. Beware of cutting/copying and pasting from a very large PDF file or webpage into MiDatabank.
This may slow down or crash the database. PDF documents can be attached if necessary, to
avoid this problem.
1.8. Do not allocate an enquiry to a colleague without notification or handover. Handover is the point
at which errors are often made or perpetuated
1.9. If at any point you need to hand over the enquiry or are unable to complete it for some reason,
leave a short clear message and your signature (Ctrl+M) in the comments box so that
colleagues are always able to ascertain the status of the enquiry without having to contact you,
e.g.



verbal answer given, letter to be written
message left at surgery for enquirer to contact us
enquirer not available - please try on Monday am
1.10. If you cannot contact the enquirer, it is important to document the date and time of contact
attempts.
2. Input
2.1. Obtain the full name of the enquirer, even if they are familiar to you. If the enquirer is not listed
(check carefully), create them as a new enquirer, including their status, usual contact telephone
number and also their address by either linking them to an organisation or by creating a new
one if necessary. It is important to check existing organisation addresses in the database as
many of them are already listed and do not need to be re-entered.
2.2. Obtain the contact details of the enquirer for this enquiry and document it in the ‘contact for this
enquiry’ field. It is acceptable to put ‘as right’ if the details match those in the top right yellow
box. Ascertain and document the caller preference for method of reply.
2.3. Record the status of the enquirer. If this is not clear in the top right yellow box, add it to the
‘Contact for this enquiry’ box. This is so that the person answering the enquiry pitches it at the
right level.
2.4. Describe the question and the background information in sufficient, clear detail to allow a third
party to tackle the enquiry without further contact with the enquirer. Record all relevant
background information, e.g. relevant medical history, concomitant medication including doses.
2.5. If the enquiry is patient-centred, you must document the patient’s name or initials, date of birth
and patient ID number (if available) in the clinical section of the input screen (bottom left hand
corner). It is also useful to document the hospital ward number for inpatients within your Trust.
2.6. If the enquiry is not patient-centred, remove the tick from the ‘patient-centred’ box in the bottom
right hand corner (the default position is that it is ticked).
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
Page 2 of 9
(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
(Signed)
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2.7. Complete the enquiry type box on the bottom right hand of the screen, choosing the relevant
fields for the enquiry. See Appendix 1 for guidance.
2.8. ‘Sign’ the input page using Ctrl+M.
2.9. Give the enquiry a title that describes the question and is as descriptive and succinct as
possible in one line, in order to facilitate access for future enquiries. If you type it as the top line
of the enquiry then the auto-title function will use it to title the whole enquiry for you. If you omit
a title, then the auto-title function will activate automatically after a short time.
2.10. Additional documentation for NHS Direct (NHSD) enquiries: see ‘Guidance for handling of
NHSD
Medicines
Call
Referrals’
on
the
UKMi
website
(http://www.ukmi.nhs.uk/filestore/ukmianhsd/UKMIGuidanceforHandlingNHSDirectMedicinesCa
llsReferrals-V3UpdatedJune2007.doc)
3. Urgency
3.1. You must use your professional judgment to negotiate a mutually realistic deadline, taking into
account the clinical urgency and current workload. Try to suggest a reasonable deadline first,
rather than asking when the answer is needed by. Ensure that the urgency and deadline are
documented clearly. If there is a particular deadline, specify the reason why.
3.2. Enquiries received by letter and email should be given a deadline according to local policy,
unless it is clear that the enquiry is more urgent. If the enquiry is received by email, send a
reply email, courteously notifying the enquirer of the deadline you have allocated and asking
them to advise you if it is required earlier.
3.3. For NHSD enquiries, see ‘Guidance for handling of NHSD Medicines Call Referrals’ on the
UKMi website:
(http://www.ukmi.nhs.uk/filestore/ukmianhsd/UKMIGuidanceforHandlingNHSDirectMedicinesCa
llsReferrals-V3UpdatedJune2007.doc)
4. Research
4.1. Document your search strategy in the order that it is carried out.
4.2. MiDatabank will record the date and time you add the name of the resource. This may be useful
if you are carrying out your search at that particular time as you will not need to document it
again.
4.3. Some resources are already in MiDatabank and will record many of the details needed.
4.4. Use a separate page for each resource, e.g. each Summary of Product Characteristics (SPC),
each database search.
4.5. ‘Sign’ each resource page at the bottom of your research using Ctrl+M.
4.6. Clearly state the titles of all resources used, with the following additional information:

Books: edition number or year of publication and page number(s).

Journals: year, volume, page number(s).

Databases: search term(s) and search strategy used.
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
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(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
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
People: full name and job title (e.g. colleagues, specialists, manufacturer Medical
Information departments (note that some manufacturers will only give employee’s first
names)).

Websites and other electronic resources: name and/or full web address, search term(s)
used, date and time accessed (if different from the date and time being recorded
automatically).

Past enquiries: search terms(s) and enquiry number.
4.7. If no information is found, record the resource as part of your search strategy and be specific,
e.g. no relevant information, drug not indexed.
4.8. If you use an MI book that is not in MiDatabank, please notify the MI Pharmacist responsible for
this so that it can either be added to the list of MiDatabank resources locally, or the up-to-date
resources can be downloaded from the MiDatabank website as appropriate.
5. Answer
5.1. Summarise the answer, ensuring that any advice is practical and appropriate to the needs of
the enquirer.
5.2. If a written format is used (e.g. a letter, fax or email), the exact text should be readily accessible
in the Answer section, either as the summary and/or as an attachment. It is good practice for
inexperienced and new members of staff to have their written format answers checked by a
competent colleague. This is also advisable for more experienced MI staff when dealing with
high risk enquiries (e.g. overtly medicolegal). If any changes are needed during the checking
process, remember to delete the incorrect text and replace with the amended version.
5.3. ‘Sign’ the answer by using Ctrl+M then tick the ‘answer ready’ box. Once the ‘answer ready’
box has been ticked, it is not possible to add anything to the input, research or answer screens.
5.4. If the answer is to be checked or authorised by a second person, they should also ‘sign’ using
Ctrl+M. For example, the person checking a letter or an answer prepared by a pharmacist in
training or a non-accredited pharmacy technician.
5.5. When feeding back to the enquirer, document any subsequent points discussed on the answer
page or completion page. N.B. In order to change anything on the answer screen, it is
necessary to un-tick the ‘answer ready’ box. Ensure that any subsequent documentation is
‘signed’ by using Ctrl+M.
6. Feedback
6.1. If an attempt to contact the enquirer is unsuccessful, leave a clear message regarding time
called, either in the comments box on the input page, or in the ‘reply notes’ box on the
completion page. Use Ctrl+M to ‘sign’ the entry.
6.2. It is good practice for the person processing the enquiry and giving the answer to be the same.
However, where this is not possible, the person giving out the answer should document this in
the reply notes section of the completion screen.
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
Page 4 of 9
(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
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6.3. Document the time at which the answer was provided if you do not complete the enquiry
immediately.
6.4. For NHSD enquiries, see ‘Guidance for handling of NHSD Medicines Call Referrals’ on the
UKMi website:
(http://www.ukmi.nhs.uk/filestore/ukmianhsd/UKMIGuidanceforHandlingNHSDirectMedicinesCa
llsReferrals-V3UpdatedJune2007.doc)
7. Completion and Statistics
7.1. There are several reasons for completion and statistical data. They are vital as evidence of who
the information was given to, what was given and when. This is important in case of complaint
or error. They are used as a management tool when planning staffing and budgets, they
demonstrate work flow, enquiry types, enquirer types and can be used to predict trends in order
to target pro-active work. It is essential that the information on the completion page is
completed accurately.
7.2. Record the route(s) of reply.
7.3. If the reply was given to a third person, record their full name and their job title if appropriate.
7.4. Document whether the answer was given out on time (NB the database defaults to on time).
7.5. Allocate the appropriate response time from the drop-down menu i.e. the time interval between
the enquiry being taken in, and the answer being given out.
7.6. Allocate an enquiry complexity level. The complexity level defaults to level 1 and many of the
queries received are levels 2 or 3. To see details of complexity levels, hover the mouse over
the drop down box.
Level 1: Data. Information only, from one or two sources.
Level 2: Searches. Multiple database and/or textbook searches. Little or no
interpretation.
Level 3: Interpretation. Specialist knowledge, interpretation, analysis and
evaluation of data. Advice given. Most written answers.
7.7. Record the time spent processing the enquiry. Automated time may be used.
7.8. Allocate relevant keywords:

Think carefully about keywords. They are used to search past enquiries for useful
information. Use the prompt list of keywords in Appendix 2 so that colleagues can search
easily using one appropriate term.

If you choose to automatically keyword the enquiry, MiDatabank will scan all enclosed text
for any keywords contained; ensure that any non-relevant keywords are removed.
7.9. Note the origin of the enquiry. Always include a local origin.

For NHSD enquiries, select the correct geographical NHSD call centre and the status of the
caller, i.e. whether they are a nurse advisor (NA), health advisor (HA) or health information
advisor (HIA)
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
Page 5 of 9
(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
(Signed)
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7.10. Once the enquiry has been fed back and all documentation completed, tick the ‘enquiry
completed’ box. NOTE: The enquiry can never be seen in the four screen format once this box
has been ticked. Do not tick until all attachments have been added.
8. Subsequent, supplementary information
8.1. If subsequent, supplementary or additional information related to the enquiry is received, this
should be documented as a note on the original enquiry. It is not possible to add attachments,
so any extra documents should be stored on an appropriate networked drive (that is backed up)
and the location of the document noted on MiDatabank, eg. using the filename and path such
as “M:\Mi08\Letters\99235.doc”
8.2. If a complaint is received about the enquiry, or the information is found to be inaccurate for any
reason, this must be documented as an Enquiry Follow up/note on the completion page of the
original enquiry and must be notified to the Head of Medicines Information or relevant Clinical
Governance lead within Medicines Information.
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
Page 6
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(Name)
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Template Approved by: UKMi Clinical Governance Working Group
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Appendix 1: Enquiry Category Guidance
Use all that are appropriate.
Administration / Dosage:
Dose? (in adults, paediatrics, neonates, renal failure, liver failure)
How to reconstitute?
How to dilute?
Infusion rate?
Route of administration?
Adverse effects:
Can drug ‘x’ cause side effect?
What are side effects of drug ‘x’?
(Does not include toxicity & poisoning (see “Toxicity” below)).
Availability/Supply/ Formulary:
Usual supplier unable to supply a drug – where else can we obtain it?
Is drug ‘x’ available in a specific country?
Can foreign drug ‘x’ be imported?
Who makes drug ‘x’?
To whom can we supply drug ‘x’?
Choice of Therapy / Indications
/ Contra-indications:
Most appropriate drug to treat certain condition?
What is drug ‘x’ being used for?
What is drug ‘x’ licensed for?
Can you give drug ‘x’ to a patient with a certain clinical condition?
Is drug ‘x’ contra-indicated if patient….is allergic to..? etc
NOT contra-indications due to interaction (see “Interactions” below).
Complementary Medicine
All complementary therapies - herbal, homeopathic, essential oils, acupuncture
etc
Drugs in Breast Milk:
Best drug for a particular condition (eg depression) or for prophylaxis if breast
feeding?
Risk of taking drug ‘x’ if breast feeding?
Drugs in Pregnancy:
Choice of drug to treat (or for prophylaxis against) particular condition during
pregnancy?
What adverse effects can occur if pregnant patient took drug ‘x’ for 5 weeks?
Is drug ‘x’ OK in pregnancy?
Identification:
Of UK drugs (eg using TicTac)
Of foreign medicines.
New drug or drug in clinical trials or drug “heard about at a conference”
Interactions:
Drug:drug (interaction NOT physical/chemical compatibility (should be
Pharmaceutical)
Drug:food.
Drug:herbal remedy. Use complementary medicine as well
Drug:biochemical test.
Page 7 of 9
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
(Signed)
<Insert Trust logo here>
Non-clinical:
Anything unrelated to the clinical use of medicines
Other:
Only use if impossible to fit enquiry into another category.
Patient-Centred Enquiry:
Automatically ticked. Remove if not patient-specific.
Pharmaceutical:
Is drug ‘x’ compatible with drug ‘y’ in a ‘y’site/bag/syringe driver etc?
Stability of drug ‘x’ out of the fridge?
Liquid formula for drug ‘x’?
What is in the formulation for product ‘x’?
Does product ‘x’ contain lactose/latex etc?
Pharmacology /
Pharmacokinetics / TDM:
How does this drug work?
What’s the half life of ‘x’?
When should you check levels of ‘x’?
What’s the usual therapeutic range of ‘x’?
Review:
Do we have general information on drug ‘x’?
Any recent reviews on use of drug ‘x’ to treat a certain condition?
Substance Misuse:
Any query relating to drugs of abuse, alcohol, tobacco.
Toxicity:
Not usually needed – most calls falling into this category will be forwarded to
the National Poisons Service.
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
Page 8 of 9
(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
(Signed)
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Appendix 2: Pharmline standard keyword terms
<Adapt according to local practice>
Use these terms to keyword enquiries or search for enquiries on MiDatabank
ENQUIRY CATEGORY/TYPE
STANDARD PHARMLINE TERM
Dose – IV drugs
Administration-intravenous
Dose – oral
Administration-oral
Dose – nasogastric
Administration-nasogastric
Dose - etc……
Administration - etc……..
ADR’s
Adverse effects
Availability
Drug Supply
Drugs in breast milk / breast feeding
Lactation
Interactions
Drug Interactions
Liver impairment
Liver Diseases
Drugs causing abnormal liver function
Liver Diseases
TDM
Drug Level Monitoring
Stability out of fridge
Refrigeration
Drug Compatibility
Drug stability
Pregnancy
Pregnancy
Renal Impairment
Kidney Diseases
Dialysis
Specify type of dialysis eg. ‘haemodialysis’
Herbal / Homeopathic Medicines
Use appropriate term from: complementary
therapies, herbal medicines, homeopathic medicines
Nasogastric feeding
Tube feeding
Nasogastric drug administration
Administration-nasogastric
Jejunostomy drug administration
Jejunostomy
Paediatric enquiries
Child or infant depending on age
Neonatal enquiries
Infant-newborn
Date of Issue: October 2008
Review Date: October 2009
Version Number: 1.0
This version adapted by:
This version approved by:
Date:
Page 9 of 9
(Name)
(Name)
Template Approved by: UKMi Clinical Governance Working Group
(Signed)
(Signed)