Nursing staff check patient information, pharmacy staff check
drug information and prescriptions until the patient receives the medication.
Dose control process: insulin management according to UI (international units) although has been implemented in the hospital before the software implementation, but still has many limitations: only controlling the distribution at the pharmacy warehouse, but not controlling the drugs used on each patient, so there is a large difference between the drugs issued by the pharmacy warehouse and the drugs used on the patient, the insulin management process is not suitable for reality. Therefore, when implementing Medisoft.THIS software, this issue has been concerned from the beginning but there is still no effective solution to manage insulin. In this situation, we have researched to find a solution to control insulin according to UI as follows:
- Build an insulin management process according to UI including a Process for departments that use a lot of insulin and a Process for departments that use little insulin (Appendix 2). In this process, the important point is that insulin is put into management in the on-call cabinet at the Clinical Department, the data is connected in the software from the Clinical Department to the Pharmacy Department, so the Pharmacy Department can easily control this amount. The same vial of insulin (1,000UI) can be used for many patients and the important thing is to calculate all the insulin costs according to UI, minimizing loss (due to syringe adhesion, i.e. waste and uncontrolled loss, i.e. loss). Thus, in improving the management process, with the support of the software: the amount of waste and loss of insulin issued by the Pharmacy Department compared to the amount used by the Clinical Department can be greatly reduced.
- Training for pharmacy staff (in warehouse and clinical department) and head nurses, IT staff.
- Implement insulin management and distribution according to UI based on established procedures
build
Table 2.2. Comparison of insulin management before and after intervention
Insulin management by department | Patient-Based Insulin Management | |
Dispensing at the pharmacy warehouse | Supplied in vials to the clinical department. sieve | UI level for clinical cabinets sieve |
History Management | Follow UI but not opposite | - Issuance according to direct compensation mechanism: warehouse |
use for | project the number between | Drugs are only added when the stock is depleted. |
patient | pharmacy stock and reality | less (in UI). |
use | - Drug management for each patient | |
- Control and compare insulin | ||
inventory at clinical duty cabinet | ||
anytime |
Maybe you are interested!
-
Perspectives on Improving the Quality of Law Application in Resolving Land Use Rights Disputes at the People's Court -
Internal control of revenue and expenditure activities at the National Children's Hospital - 2 -
Quality of Law Application in Resolving Land Use Disputes at People's Courts -
Assessment of the Current Status of the Policy on Developing Female Human Resources in the People's Public Security Force -
Tourists' Reviews of Local People's Service Quality of Homestay Tourism in Binh Ba Island
Apply information technology to the system of processes built in step 1
The software deployed is Medisoft THIS of Global Links Company. This is a comprehensive management software that includes all relationships, especially research-related subsystems such as hospital information system (including eRx and patient information management), pharmacy subsystem.
2.4. PERFORMANCE ASSESSMENT INDICATORS IN THE TOPIC
2.4.1. Quality of drug list
The quality of the drug list in the study was assessed through the structure of drug groups according to ABC/VEN analysis. The quality of the drug list was shown through the reasonable proportion of essential and critical drug groups (V and E) accounting for a high proportion, on the contrary, the proportion of non-essential drug groups (N) accounting for a low proportion, not too many non-essential drugs in the group that uses a lot of budget (group A).
Table 2.3. Variable groups of ABC analysis
Specific variable
Variable type | Index/ definition | |
A | Quantitative | - Percentage by number of group A - Percentage according to group A value |
B | Quantitative | - Percentage by number of group B - Percentage according to group B value |
C | Quantitative | - Percentage by number of group C - Percentage according to group C value |
Table 2.4. Variable groups of VEN analysis
Specific variable
Variable type | Index/ definition | |
V | Quantitative | - Percentage by number of groups V - Percentage according to group V value |
E | Quantitative | - Percentage by number of group E - Percentage according to group E value |
N | Quantitative | - Percentage by number of groups N - Percentage by group N value |
Table 2.5. Variable groups of ABC/VEN matrix analysis
Specific variable
Variable type | Index/ definition | |
Group I | ||
AV | Quantitative | - Percentage by number of AV groups |
- Percentage according to AV group value | ||
AE | Quantitative | - Percentage by number of AE groups |
- Percentage according to AE group value | ||
AN | Quantitative | - Percentage by number of AN groups |
- Percentage according to AN group value | ||
BV | Quantitative | - Percentage by number of hospital groups |
- Percentage according to BV group value | ||
CV | Quantitative | - Percentage by number of CV groups |
- Percentage by CV group value | ||
Group II | ||
BEIGE | Quantitative | - Percentage by number of BE groups |
- Percentage according to BE group value | ||
CE | Quantitative | - Percentage by number of CE groups |
- Percentage according to CE group value | ||
BN | Quantitative | - Percentage by number of patient groups |
- Percentage according to patient group value | ||
Group III (CN) | Quantitative | - Percentage by number of CN groups - Percentage by group value |
2.4.2. Prescription quality
Prescribing quality is measured by the number and type of errors: prescribing quality is good if the number of errors is minimal.
Table 2.6. Variables for assessing prescribing quality
Specific variable
Variable type | Index/ definition | |
Patient information errors regarding: - Full name, age, gender - Address | Quantitative | - Percentage of prescriptions missing full name and gender = (number of prescriptions missing name and gender/500)*100 - Percentage of prescriptions missing address = (number of prescriptions missing patient address) times/500)*100 |
Error in indication according to ICD | Quantitative | Percentage of prescriptions not prescribed by prescription ICD = (number of missing prescriptions/500)*100 |
Error in writing drug name, active ingredient name | Quantitative | Percentage of prescriptions with missing drug names and active ingredients = (number of prescriptions with missing names) remaining/500)*100 |
Error in user manual medicine | Quantitative | Percentage of prescriptions with missing directions Medication instructions = (number of missing prescriptions) remaining/500)*100 |
- Proton pump inhibitors | Quantitative | Percentage of prescriptions lacking instructions for use proton pump use = (number of prescriptions) (missing)/500)*100 |
- Diabetes medication | Quantitative | Percentage of prescriptions lacking instructions for use diabetes medication = (number of prescriptions) medicine deficiency/500)*100 |
- Antibiotics nonsteroidal anti-inflammatory drug | Quantitative | Percentage of prescriptions lacking instructions for use NSAID use = (number of prescriptions missing) remaining/500)*100 |
- Drugs for treating disorders lipid disorders | Quantitative | Percentage of prescriptions lacking instructions for use Drug use for lipid disorders = (number of prescriptions) medicine deficiency/500)*100 |
2.4.3. Quality of inventory control
Inventory control quality : is to ensure that drugs are always available in stock (minimizing out-of-stock drugs and ensuring accurate inventory data (shown through matching book data and actual data).
Table 2.7. Variables for assessing the quality of inventory control
Specific variable
Index/ definition | How to calculate | Desired level | |
1. Data percentage Exactly | Determine the quality of storage system | Key Data total/2,500 | 100% |
1a. Percentage of book data less than actual data (surplus) | Determine the ratio of book inventory to actual inventory (surplus) | Redundant data/total (2,500) | 0% |
1b. Percentage of book data being greater than actual data (missing) | Determine the ratio of book inventory to actual inventory (shortage) | Missing data/total (2,500) | 0% |
2. Percentage of inventory change compared to total inventory | Indicate the level of error in inventory management | Total [Absolute value (book data – actual data)]/total actual inventory (sum of all actual quantities) | 0% |
3. Product % available products | Measures the system's ability to maintain product availability at the time of evaluation | Total (actual figures) >0) /total (2,500) | 100% |
4. Average % of time product is out of stock | Indicates the system's ability to maintain a steady supply of product at all times by minimizing out-of-stock times. | Total empty days (0)/ total (2,500) | 0% |
2.4.4. Quality control of divided dose drugs
Quality of split-dose medication control: Split-dose medication control is the management of medication at doses smaller than the smallest packaging unit, such as insulin packaged in 1,000 IU vials but using only 20 IU at a time. This management is considered good when waste (syringe sticking, medication spilling out, etc.) and loss (due to differences between clinical data received from the pharmacy and actual data on patients) are minimal.
Table 2.8. Variables for assessing the quality of dose control of divided drugs
Specific variable
Variable type | Index/ definition | |
- Amount of insulin issued by the Pharmacy Department | Quantitative | (Waste, loss of insulin issued by the Pharmacy Department) - (Waste, loss of insulin used by the clinical department) by quantity |
- Insulin quantity Science clinical use | Quantitative | |
- Insulin value issued by Pharmacy Department | Quantitative | (Waste, loss of insulin issued by the Pharmacy Department) - (Waste, loss of insulin used by the clinical department) according to value |
- Insulin value Clinical science ready to use | Quantitative |
2.5. DATA COLLECTION AND PROCESSING
To assess the quality of the drug list , we retrospectively reviewed consumption data and drug costs for each drug in 2006 (TCT), 2008 (TCT), and 2010 (TCT).
(SCT) calculates quantity and value by active ingredient, using ABC/VEN analysis method to analyze data.
ABC analysis, the annual cost of each active ingredient is ranked in descending order. The cumulative cost of all active ingredients, the cumulative cost percentage and the cumulative percentage by number of varieties are also calculated. The list is then divided into groups A, B and C based on the cumulative percentage by value of 70%, 20% and 10% respectively.
VEN analysis, VEN analysis for all active ingredients in the list is performed by classifying active ingredients into groups of essential (V), essential (E), non-essential (N). Active ingredients that are essential for patient survival and must be available at all times are classified into group V. Active ingredients that are of lower demand and must also be available in the hospital are classified into group E. The remaining active ingredients with the lowest level of importance, the shortage of which does not affect the patient's health, are classified into group N. The VEN classification of each active ingredient is agreed upon by the Drug Administration and the Drug Control Board.
ABC/VEN Matrix Analysis: Cross-combine ABC analysis and VEN analysis. The cross-analysis results are classified into groups I, II, III. Group I includes AV, AE, AN, BV and CV. Group II includes BE, CE, BN. Group III includes CN.
Table 2.9. Combination of ABC analysis and VEN classification
V | E | N | ||
A | AV | AE | AN | The most important medicine |
B | BV | BEIGE | BN | Important medicine |
C | CV | CE | CN | Least important medicine |