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KMID : 0869620060230040304
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Journal of Korean Society of Hospital Pharmacists
2006 Volume.23 No. 4 p.304 ~ p.309
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Performance Improvement for Reduction of Discarded UDS-parenteral Medications
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Park Yun-Hee
Kim Min-Sun
Kim Jung-Tae
Kim Jae-Youn
Shin Hye-Young
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Abstract
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A unit dose drug distribution system for parenteral medications (pUDS) is characterized by the delivery of parenteral admixture prepared in pharmacy services to patient care areas in single unit packages just prior to the moment of administration. Although pUDS is safe and efficient, it generates a large amount of waste and causes an economic loss. Accordingly, we analyzed the cause of discard of parenteral medications and performed some improvement to minimize the discarded UDS-parenteral medications. The rate and reasons of waste occurred in the oncology ward was measured by chosen pUDS-applied wards giving surveys for one month. Then we analyzed the cause using the fishbone chart. The waste rate was 6.74% (232 waste cases) and the waste cost was ￦1,211,146. The reasons of waste were 1) discontinued medications by the physician (99 cases; 43%), 2) discharged patients (56 cases; 24%), 3) expired patients (31 cases; 13%), 4) prescription error (13 cases; 7%), and 5) others (31 cases; 13%). The improvable activities were performed: 1) nurses inform the pharmacy immediately by reporting that such order was canceled or the patient discharged, 2) physicians makes an effort to prescribe correctly 3) pharmacist obtain the information of dating of i.v. admixtures and mark expiration dates on the label, while pharmacy did not prepare emergency and prearranged discharge medications, and 4) clinical pharmacist adjusted unnecessary set order of order-communication systems for chemotherapy. After executing the performance improvement for three months period, before and after the change was reported. The rate of waste decreased significantly 2.32 % (p＜0.001), and the cost of discarded medications reduced 31% (￦1,261,146 to ￦849,597). This department’s performance improvement has resulted in substantial reductions in the discarded medications and expects to save in the costs of waste and to establish pUDS.
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KEYWORD
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Unit dose system, Parenteral medications, Wastage
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