Introduction
Certain types of syrup medications, especially antibiotics, are freshly reconstituted in pharmacy upon receipt of prescriptions from physicians. Under previous practice, the use-before dates are manually calculated and filled on drug labels by dispensers after reconstitution. Auxiliary labels of “Refrigerate” are also stuck accordingly if appropriate. Information is thus checked by another dispenser and then pharmacist before issuing. Although there are information charts assisting colleagues in checking shelf life and storage condition of individual medications, the following challenges exist: 1. There is a range of medications that require fresh reconstitution. Effort is needed for colleague to check and calculate each time for the use-before dates and storage conditions. 2. Manual error may occur during calculation process. 3. Poor handwriting and/or diffusion of ink may lead to difficulty in reading information from the labels.
Objectives
This project aims to: 1. Improve medication safety through replacing manual written labels by automatic printing 2. Ensure patients will not be using an expired product due to incorrect use-before date 3. Optimize dispensing process and improve efficiency 4. Improve tidiness and neatness of dispensing labels for better readability by patients/carers or nursing staff when administering the drug
Methodology
To improve the current practice and quality of dispensing, a computerized program is designed to calculate and print use-before date and auxiliary label automatically from label printer after scanning barcodes which is originally printed on dispensing labels.
Results & Outcome
This project targets to achieve the following outcomes: 1. Elimination of wrong calculation or writing of use-before date and wrong labelling of “refrigerate” after medication reconstitution 2. Elimination of poor readability of manual writing of use-before date, so as to safeguard correct medication administration and patient safety 3.Reduction of pharmacy staff workload and optimization of dispensing process. Zero near miss of incorrect use-before date and refrigerate instruction was recorded since implementation in AHNH main pharmacy and TPH main pharmacy. Improvement of dispensing efficiency is evaluated by interviewing dispensing staff (pharmacists and dispensers) after implementation. All staff interviewed agreed new measure can reduce workload for manual calculation, reduce frontline stress and increase dispensing accuracy and efficiency. Questionnaires were distributed to patient/carers and nursing staff. 100% of respondents are satisfied with the new measure. Most respondents agreed that new measure can improve tidiness of instruction, reduce mistakes and misunderstanding of information, and hence improve medication safety.