Authors (including presenting author) :
Chu ST(1), Chan WY(1), Ng HW(1), Sun WL(1)
Affiliation :
(1)Accident & Emergency Department, United Christian Hospital
Introduction :
With the expansion of the Accident & Emergency Department (AED) service, there had been an increase in the variety and amount of drugs stored and used in AED. Finding a drug item in AED becomes a difficult task for nursing staff, resulting in delay of drug administration and potential drug errors. Our aim is to develop a systematic drug management system and streamline the workflow; this project was launched in Jan 2019.
Objectives :
(1) To develop a drug management system in AED
Methodology :
We adopted the Plan-Do-Check-Act (PDCA) cycle to continuously improve the drug management. Our onsite review identified the following areas for improvement, including (1) no drug stock list index was displayed in Emergency Medicine Ward (EMW) and Observation room (O room), (2) drug stock baseline were insufficient in EMW and O room, and (3) disorganized drug storage in EMW. The first PDCA cycle targeted at (1) establishing a drug index and posting it in EMW and O room, (2) reviewing the drug stock list and (3) reorganizing the drug storage in EMW. By the end of the project, feedbacks from colleagues were collected for evaluation and preparation of a new PDCA cycle.
Result & Outcome :
Results: Project targets were accomplished in October 2019. The outcomes were as follows: (1) A drug stock index was established and posted in EMW and O room, (2) drug stock list was reviewed by AED medication team and (3) ward stock drug items in EMW were reorganized and the storage location was changed from a mobile trolley to a wall-mounted cabinet to enhance accessibility. The feedbacks from AED colleagues were collected and concluded as follows: (1) the drug stock index facilitated the retrieval of drugs, (2) the types and amount of drug stock in EMW and O room met the operational needs, (3) the drug storage in EMW was more organized than before and (4) more drug items should be included to reduce drug wastage; a significant amount of drugs were discarded due to short length of stay of patients in EMW and O room. Also, we set up a new regular routine to review the drug stock items. The next review would be carried out in Jun 2020. A new PDCA cycle would be conducted to look into the feasibility of expanding the ward stock to minimize drug wastage. Conclusions: The drug storage management system facilitated the efficiency of the workflow through the establishment of the drug stock index, review of drug stock list and reorganization of drug storage. The application of PDCA cycle in this project helped us to set up a continuous improvement plan for drug storage management.
