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KMID : 0869620140310040882
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 4 p.882 ~ p.887
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Timely Administration of IV Vancomycin in a General Hospital Pharmacy
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Park Hee-Joo
Choi Yu-Ri
An Sung-Sim
Choi Sun
Kim Soon-Joo
La Hyen-O
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Abstract
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As interest in patients’safety has been increasing, the timely administration of scheduled medication is being more and more emphasized. In 2013, the research hospital established the guideline for‘ time-critical medications (TCM)’based on the‘30-minute rule’from the Institute for Safe Medication Practices (ISMP) and the ‘medication management and use (MMU) standard’of the Joint Commission International. According to this guideline, if the maintenance doses of these medications are administrated early or delayed for more than 30 minutes before or after the scheduled dose, such effect may cause harm or result in substantial sub-optimal therapy or pharmacological effect. The research hospital has a total 125 TCMs, including those medications that need therapeutic drug monitoring. At the pharmacy, before prepared TCMs are delivered to each ward, warning labels are attached to each TCM during the inspection procedure by charging pharmacists. If delayed or early administration of TCM occurs, it should be reported as a near miss to the internal patient safety management program. Among these time-critical medications, this research was conducted on vancomycin of which dosing time could significantly affect the maintenance of therapeutic plasma concentration. From April to August 2013, vancomycin administration status (administration time adherence, and the reason of early or delayed administration, where applicable) was inspected at the wards of pulmonary medicine, internal medicine intensive care unit, and emergency center. Overall, vancomycin was administrated a total 1,638 times in 167 patients in 3 investigated
departments. Except for the 563 first doses, the administration time of 997 cases was adhered
(administration time adherence rate = 92.74%, 997/1,075). The reason for early or delayed administration
was omitted in most cases (61.54%, 48/78). The most frequently marked reason for such
action was the‘ change of the administration time based on the TDM result or change the ward’
(26.92%, 21/78) and‘ other medical care procedures(operation, lab test , etc)’(11.54%, 9/78).
The adherence rate of vancomycin timely administration was high and well maintained in the
research hospital. Pharmacists also played an important role in this favorable result. Further
sustained education of healthcare professionals will be needed for a more detail management of
some early of delayed administration.
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KEYWORD
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Timely administration, Vancomycin, Patient safety management
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