Improving Medication Safety and Efficiency in managing Unissued Medications in In-patient Pharmacy --- Utilization of an Electronic Drug Checking System

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Abstract Summary
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Authors (including presenting author) :
Cheung DST, Lai EOL, Wong HSY, Tsoi HHY, Ho VKW, Leung KHL, Lui WWY, Sin TK, Ng PH, Kong HS, Wong CFF, Chui WCM
Affiliation :
Department of Pharmacy, Queen Mary Hospital
Introduction :
Inpatient Medication Order Entry (IPMOE) supports the identification of dosage modification and inactive prescriptions at the point of performing drug checking by Pharmacists, to reduce unnecessary drug supply to inpatients. This results in a considerable volume of unissued medications that require to be returned to drug shelves. The unissued medications are currently manually counter-checked and returned by two Dispensers. With the frequent return of look-alike and sound-alike medications and loose tablets or small blisters, potential risk of medication misplacement is incurred.
Objectives :
- To enhance medication safety in the drug distribution process. - To increase the accuracy of returning the unissued medications to the right locations by utilizing the electronic drug checking and 2D barcode code scanning system. - To save manpower in the drug return process.
Methodology :
An Electronic Drug Checking System utilizing barcode scanning technology is employed to facilitate the process of returning unissued medication to drug shelves in In-patient Pharmacy. 2D barcode, containing information on drug name, dosage form and strength, are displayed on shelf label. Standard procedure of using the Electronic Drug Checking System: 1. Unissued medications are collected in designated trays. Two Dispensers counter-check the drugs against the dispensing labels to ensure the right drug. 2. By cross matching the 2D barcodes on the shelf label and dispensing label with a handheld scanner, returning of the right drug to the right location can be verified by a “matched” signal. 3. The process of returning the counter-checked, unissued medications to drug shelves can be performed by one Dispenser with the help of the Electronic Drug Checking System.
Result & Outcome :
From October to November 2018, there were total of 3187 unissued injection and non-injection items returned to drug shelves (1396 injection, 1791 non-injection items). The accuracy of Dispensers in returning the unissued medications by the Electronic Drug Checking System was 99.6%. There was an average reduction of 4.1 man-hours per week in the return process. The Electronic Drug Checking System is useful in improving medication safety in managing unissued medications in In-patient Pharmacy, and improving the efficiency of Dispensers in returning the unissued medications.

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