Authors: (including presenting author): :
LEE WY (1), FUNG WC (1), CHUI ST (1)
Affiliation: :
(1) Central Nursing Division, Prince of Wales Hospital
Keyword 1: :
Dangerous Drug
Keyword 2: :
Smart DD Cabinet
Keyword 3: :
Medication Safety
Introduction: :
Dangerous drug (DD) management requires strict compliance with regulatory standards and meticulous record keeping. Traditional storage and manual documentation are time consuming and prone to human error. In the new inpatient extension block (IPEB) at Prince of Wales Hospital (PWH), fixed space was allocated for DD storage. To address these challenges, a Smart DD System was developed, comprising a size fitted DD cabinet paired with a DD refrigerator. This integrated solution combines secure access, electronic verification, temperature monitoring, and electronic ledger recording to improve safety, streamline workflow, and ensure compliance with DD management requirements.
Objectives: :
The project aimed to: 1. Enhance medication safety by ensuring accurate patient drug matching and secure access to DD. 2. Streamline workflow through automating storage, retrieval, and record keeping. 3. Integrate monitoring functions such as temperature logging and alarm alerts. 4. Establish an electronic DD ledger to improve accuracy and efficiency.
Methodology: :
The Smart DD System was custom designed for general wards in IPEB through collaboration among nurses, pharmacists, IT colleagues, and vendors. Nurses log-in using smart staff cards. By scanning the patient’s hospital number (HN), DD prescriptions are retrieved directly from the Inpatient Medication Order Entry (IPMOE) system. Selecting the required DD triggers automatic unlocking of the corresponding bin. Each transaction electronically calculates stock levels, nurses verify required and remaining quantities, and signed by using staff card authentication. All DD transactions are captured in an electronic ledger. Unauthorized cabinet access immediately triggers alarms on the nursing dashboard, with future plan to repeat alarms to nursing PDAs for prompt response. The paired DD refrigerator continuously logs temperature, and any out-of-range temperature generates alerts in the same way, ensuring secure and compliant storage.
Result & Outcome: :
The Smart DD System prototype has been proven feasible in general ward settings. It enhanced safety by reducing risks of mismatch, incorrect records, unauthorized access, and temperature excursions. Workflow efficiency improved through automated bin unlocking and electronic ledger recording. With electronic DD ledger providing real-time visibility into inventory, future collaboration with pharmacy will focus on optimizing stock keeping and replenishment, advancing toward a fully integrated, closed loop DD management system.
