Authors (including presenting author) :
Wong MY(1), Kam KW(1), Mak CK(2), Mak LKK(1)(2)
Affiliation :
(1)Department of Pharmacy, Haven of Hope Hospital, (2)Department of Pharmacy, Tseung Kwan O Hospital
Introduction :
Haven of Hope Hospital (HHH) pharmacy as an extended-care hospital does not provide round-the-clock pharmacy service. It created a loophole for medication error as medication prescribed during HHH pharmacy non-office hours were administered to patient without prior verification and dispensing by pharmacists in the old days. Medication incidents were discovered during retrospective medication verification by pharmacists when pharmacy resumed service. However, an opportunity to complete the loophole rose with the full implementation of Inpatient Medication Order Entry (IPMOE) System in HHH in November 2018. Cluster-based inter-hospital after-hours pharmacist verification was explored in the hope to facilitate the imperative role of pharmacists to promote medication safety by performing prospective medication verification for prescribed orders where potential medication errors can be intervened timely.
Objectives :
To evaluate the implementation of IPMOE pharmacist verification support by TKOH pharmacy during HHH pharmacy non-office hours.
Methodology :
With the support from Chief Pharmacist’s Office and senior management of HHH and TKOH, inter-hospital after-hours pharmacist verification supported by TKOH for HHH was launched successfully since 1st December 2018. Apart from the remote verification service, round-the-clock accessibility to pharmacist was made available to HHH healthcare members. They are encouraged to consult TKOH pharmacists for any drug information enquiry during HHH pharmacy non-office hours. Drug-related interventions and information enquiries are documented for study and analysis to aid the review of existing practice and develop preventive measures in the future.
Result & Outcome :
From 1st December 2018 to 30th November 2019, about 160 HHH IPMOE orders were verified by TKOH pharmacists per week during remote medication verification service. 113 drug-related interventions and recommendations were made, including renal-dose adjustment(43), therapeutic duplication(23), inappropriate infusion rate or dilution(10), inappropriate frequency(8), discrepancy from local policy(7), unsuitable dosage form(4), improper choice of drug(4), unfitting administration of medication scheduling(4), unclear remarks(4), inappropriate dosage(2), improper route of administration(2), suboptimal duration of regimen(1), drug-drug interaction(1).
9 drug information enquiries by doctors(1) and nurses(8) were handled: drug allergy enquiry(4), dosing enquiry(2), drug appearance enquiry(1), adverse drug reaction enquiry(1), IPMOE technical problem(1).
The inter-hospital after-hours pharmacist verification supported by TKOH fills the loophole of retrospective medication verification in traditional practice at HHH, where in-house round-the-clock IPMOE verification service was lacked; hence, it dramatically improves medication safety.
