Until recently, the practice in public hospitals was to record the time when the physician orders the medication.  The actual time when the patient receives the medication and the name of the staff member administering it was not a part of the medical record.  This is a critical data element providing indispensable information and benefits.  First, it provides evidence that patients have actually received their medication as prescribed.  Second, it introduces accountability measures as an essential staff duty and strengthens patient safety by reducing medication administration errors.  Lastly, it improves transparency by establishing a record linking the multi-million dollar hospital procurement and distribution of pharmaceuticals system, cited often in studies on corruption in Albania's health sector, with its intended beneficiary - the patient.

With support from the USAID’s health governance project, public hospitals in Albania have changed how they administer and record the medication practices. The change started in the context of a long-term hospital management effort piloted at the regional hospitals of Lezha and Korça and the Maternity Hospital No.1 in Tirana.  Discussions with the staff and leadership of the two regional hospitals on patient safety and pharmaceutical management were conducted, followed by trainings on management of pharmaceuticals and medication administration recording.  As a result, the staff and leadership of the hospitals showed genuine interest and enthusiasm in improving their current medication administration and management practices.

The regional hospital in Korça piloted the initiative by implementing a new medication recording system. The Lezha Regional Hospital followed suit.  Nurses were trained in the new practice and the two hospitals proceeded to order new patient records reflecting the new rules.

Recognizing the benefit of piloted changes in the patient record, the Health Reform Implementation Support Group, an institutionalized health reform advisory board to the Minister of Health, has recommended the introduction of medication administration in all public hospitals.  The nationwide implementation of the medication administration record will improve patient safety; strengthen the transparency in the health system and the accountability of medical staff.