Authors (including presenting author) :
SM Lee (1), Billy Wong (1), WM Ching (1) , WY Leung (1)
Affiliation :
(1) Accident & Emergency Department, Pok Oi Hospital
Keyword 1: :
medication safety
Keyword 2: :
dispensing efficiency
Keyword 3: :
dangerous drugs
Keyword 4: :
Automatic Dispensing Cabinet
Keyword 5: :
elimination of manual drug prescription
Keyword 6: :
emergency setting
Introduction :
Nowadays, the use of Automatic Dispensing Cabinet (ADC) is being a new trend in daily practice in order to enhance medication safety and dispensing efficiency. It ensures that the medication list is accurate, complete and clinically appropriate at every transition of care, especially in emergency setting. System checking for drug allergy and drug interaction can be achieved through integration of ADC with IPMOE, eResus and CMS databases, which reduce medication errors and support timely medication administration particularly in high-volume and high-risk clinical areas. POH AED have implemented the use of ADC since 12th June 2024.
Objectives :
To enhance medication safety during drug retrieval and provide a more timely and accurate drug dispensing processes in AED.
Methodology :
The implementation of ADC was divided into 3 phases because it is a new workflow for staff. Implementation from simple to complex cases of medication retrieval will facilitate staffs’ adaptation and confidence for using ADC. Phase 1: --For category 3, 4 and 5 cases only, which allow staff to be more familiar with the drug retrieval process in less urgent situation. --Medications prescribed by IPMOE can be retrieved from ADC. --Pharmacist verification was required for some high-risk medications such as aspirin and urgent first-dose antibiotics. Phase 2: -- Practice was extended to category 1 and 2 resuscitation cases. -- Medications can be retrieved from ADC by prescribing in IPMOE, eResus and even verbal order. --During emergency situation, staff will be able to access all drugs stored in the ADC. Staff are reinforcing to check the drug allergy history, adverse drug effect and on anti-coagulant before drug administration when using those modes which pharmacist verification was not required. Phase 3 : --In the last phase, Dangerous Drugs (DD) can be retrieved from ADC with electronic DD ledger available. --Implement the two-man rule to securely dispense dangerous drugs, witness was required by a second authorized user of the system.
Result & Outcome :
Providing quality patient care is the core responsibility of a caregiver, and ensuring the right drugs are given to the right patient at the right time is of utmost importance to positively impact the patient’s recovery journey. After implementation of the use of ADC in POH AED, there is no medication incidents related to wrong drug, wrong route and wrong dose administrated to patients. Besides, elimination of manual drug prescription and drug retrieval was achieved too, which resulting in increased operational efficiency and ensured medication safety.
