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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-10Reducing the Number of Expired Psychotropic Medications at Clinic-BasedEmergency Departments in Dungun, TerengganuKhadijah Qistina MS1, Leong WC2, Aishah I3, Aina Husna M4, Zulaimah S21Ketengah Jaya Health Clinic, Dungun District Health Of ice, Terengganu State Health Department2Paka Health Clinic, Dungun District Health Of ice, Terengganu State Health Department3Kuala Abang Health Clinic, Dungun District Health Of ice, Terengganu State Health Department4Al-Muktafi Billah Shah Health Clinic, Dungun District Health Of ice, Terengganu State Health Department.SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:In Dungun, Terengganu, expired psychotropic injections and rectal preparations in clinic-basedemergency departments (ED) increased from 31 to 60 items over two years (April 2020 %u2013 March 2022),highlighting potential medication errors. This project aims to reduce expired psychotropic medications inED.KEY MEASURES FOR IMPROVEMENT:The standard is zero expired psychotropic medications as required by Penyeliaan Farmasi ke FasilitiKesihatan Primer.PROCESS OF GATHERING INFORMATION:From January 2022 to March 2024, a quality improvement project involving clinic-based ED andpharmacy departments in Dungun was conducted with a verification study, two intervention cycles, and asustainability study. Psychotropic medication records were utilised to track expired items, a questionnaireinvolving 20 medical assistants to explore contributing factors, and a work process checklist to assessMOGC adherence.ANALYSIS AND INTERPRETATION:60 expired psychotropic medications were found during pre-intervention. Contributing factors includepoor implementation of first-expired first-out rule (85%), late action taken on slow-moving near-expiryitems (75%), difficulty in identifying slow-moving near-expiry items (60%), and inconsistent stockmonitoring (60%).STRATEGIES FOR CHANGE:Cycle 1 featured guidance sessions for medical assistants by pharmacists, a standardised documentationguideline, and a reminder note. Cycle 2 introduced auxiliary labels and PsyMon mobile applicationdevelopment for remote stock monitoring by pharmacists.EFFECT OF CHANGE:The number of expired psychotropic medications dropped to 3 after cycle 1. The standard was achievedpost-cycle 2 and sustained throughout the sustainability study. Upon project completion, MOGCadherence improved in returning slow-moving near-expiry items, labeling and isolating stock withvarying expiry dates, tagging near-expiry stock (20% to 100%), routine stock checking (35% to 100%),and documenting medication usage and stock balance with expiry dates (35% to 90%). Near-expiry itemsworth RM3,019 were salvaged from wastage.THE NEXT STEP:The auxiliary labels%u2019 use was expanded to floor stock medications. PsyMon was introduced to otherhealthcare facilities in Terengganu and adopted in two facilities. The expansion in PsyMon%u2019s function tostreamline other work processes is explored.61 | Page