Page 51 - Demo

Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024OP-25Improving Appropriate Management of Chemotherapy Drug in Pediatric Oncology,Hospital Tunku AzizahFarizan AG,1 Mohd.Haz Hairul A2, Rizal Husaini R2, Radhika TSN2, Nik Nabilah NMS2, Yee Shen Loo2,Siti Syahirah Alyaa S2, Zulaiha M3, Kok Hoi Teh3, Irdawati AW4, Marlina R4, Muzlinihaiyu ML41Pharmacy Department, Hospital Kuala Lumpur, Kuala Lumpur2Pharmacy Department, Hospital Tunku Azizah, Kuala Lumpur3Paediatric Department, Hospital Tunku Azizah, Kuala Lumpur4Nursing Unit, Hospital Tunku Azizah, Kuala LumpurSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Low percentage of appropriate management of chemotherapy drugs in paediatric oncology ward directlycontributed to a sentinel event where patients received double dose. Our study aimed to improveappropriate management of chemotherapy drugs in paediatric oncology.KEY MEASURES FOR IMPROVEMENT:The indicator was measured using the percentage of patients with appropriate management ofchemotherapy drugs. The standard is set at 95% based on R.Ashokkumar et al. (2018) and consensusamong team members.PROCESS OF GATHERING INFORMATION:A quality improvement study involving all chemotherapy paediatric patients in Hospital Tunku Azizahwas conducted from February 2023 to July 2024. Two cycles of remedial measures were implemented forsix months and four months, respectively with a total of 130 subjects. Prescription, tailored checklist, andself-administered questionnaire were used to track the percentage and contributing factors of appropriatemanagement of chemotherapy drugs.ANALYSIS AND INTERPRETATION:The verification study demonstrated only 76.4% of appropriate management involving prescribing,dispensing, and storing chemotherapy drugs were practiced by healthcare providers (HCPs). Lack ofknowledge among HCPs (33.3%), wrong patient and medication details documented (22.2%), inadequatecounterchecking (18.5%), and unfamiliarity with prescribing methods (18.5%) contributed to thisproblem.STRATEGIES FOR CHANGE:Standardised chemotherapy protocol templates and worksheets comprising 240 chemotherapy regimensfor 45 types of cancers were developed. %u2018KiddoInfuse%u2019, a freely-accessible mobile app was innovated bypharmacists to customize infusion volume of chemotherapy based on patients%u2019 specific factors andprotocols. Training and demonstration on the protocols and %u2018KiddoInfuse%u2019 were conducted among HCPs.EFFECT OF CHANGE:The percentage of appropriate management of chemotherapy drugs increased from 76.4% to 87% (1stCycle), then improved to 93.1% (2nd Cycle). ABNA improved from 18.6% to 8.0%, and finally to 1.9%.All contributing factors and the model of good care have improved.THE NEXT STEP:We plan to enhance 'KiddoInfuse' by adding more chemotherapy drug details, improving app security, andproviding regular updates. We aim to disseminate our findings to other hospitals to facilitate replication.50 | Page