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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-07Improving Appropriate Use of Intravenous Immunoglobulin (IVIG) in NeurologicalDisorders at Hospital Kuala LumpurFarizan AG1, Tan AL1, Dhayalen K2, Ziran Nadiah G1, Yeak CY1, Hazrin MR1, Wan Noor Hazimah WH1,Noradlina R1, Mohd Izwan CN21 Department of Pharmacy, Hospital Kuala Lumpur2 Department of Neurology, Hospital Kuala LumpurSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Appropriate use of Intravenous Immunoglobulin (IVIG) is defined as its correct indication, dose,frequency, duration and administration. Verification study conducted from October to December 2021found 61.2% of IVIG used in neurological disorders was inappropriate, risking unfavourable clinicaloutcomes and up to 15% incidence of adverse events.KEY MEASURE FOR IMPROVEMENT:This study aims to increase the percentage of appropriate use of IVIG in neurological disorders, with astandard of %u226595%, based on an ICU study by Foster et al (2010).PROCESS OF GATHERING INFORMATION:A quality improvement study was conducted from 2022 to 2023 at neurology wards and clinics, assessingthe appropriateness of IVIG treatment through IVIG usage records, data collection form and questionnaireamong healthcare personnel.ANALYSIS AND INTERPRETATION:Survey findings from the verification study identified that easy IVIG accessibility, uncertainty aboutindications, improper administration and dosage, prolonged treatment duration, and the absence ofstandardised guidelines were key factors contributing to 61.2% of inappropriate IVIG use.STRATEGIES FOR CHANGE:In Cycle 1, the main focus was to streamline the indications by prioritising peripheral nervous systemdisorders and initiation of treatment by consultant only. IVIG infusion guide was developed to educatenurses. During Cycle 2, IVIG indication priority table was developed, categorising neurological disordersinto four classes based on clinical evidence. Smart IVIG calculator and IVIG administration chartfacilitated accurate dosage calculations and proper monitoring for physicians, pharmacists and nurses.These strategies ensure IVIG is used appropriately.EFFECT OF CHANGE:The percentage of appropriate use of IVIG in neurological disorders improved from 38.8% to 52.3% inCycle 1 and to 87.0% in Cycle 2. ABNA was reduced from 56.2% to 42.7% and finally 8%. Additionally,proper monitoring allows early detection of infusion-related reactions thus improving patient safety.THE NEXT STEP:An IVIG guideline in neurological disorders will be developed and reviewed by consultant neurologistsand pharmacists, intended as a standard for other departments within HKL and neurology centresthroughout Malaysia.32 | Page