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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024PP-27Reducing the External Galenical Preparation Errors among Northern SeberangPerai ClinicsWan Y1, Nurul Jannah S2, Ooi HL3, Nor Aishah I4, Anis Humaira M2, Suriati S5, Nursyafikah MS3,Muhammad Alif Halimi AK31Butterworth Clinic, Northern Seberang Perai, Penang2 Tasek Gelugor Clinic, Northern Seberang Perai, Penang3 Mak Mandin Clinic, Northern Seberang Perai, Penang4 Sungai Dua Clinic, Northern Seberang Perai, Penang5 Kepala Batas Clinic, Northern Seberang Perai, PenangSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:Galenical preparation is the preparation of creams, lotions, and oral solutions that are not availablecommercially. A retrospective study (2022) revealed that, across six clinics in Northern Seberang Perai(SPU), 58.3% of the external galenical preparation (EGP) had varying in-use expiry dates and incompletelabels. These EGP errors may lead to ineffective treatment and increased cost of wastage. This work aimsto reduce EGP errors.KEY MEASURES FOR IMPROVEMENT:The indicator was measured by the percentage of preparation with errors over the total external galenicalprepared. The standard is 0% preparation errors as medication errors can lead to serious clinicaloutcomes.PROCESS OF GATHERING INFORMATION:This quality improvement study was conducted at six clinics in SPU from May 2022 to July 2023involving two cycles post-remedial implementation between August 2022 to May 2023. All observedEGP errors were included in the analysis. Indicator data were collected in data collection forms whileknowledge was assessed using online questionnaires.ANALYSIS AND INTERPRETATION:The baseline of EGP errors was 61.1%. The main contributing factors were incomplete documentation(89.5%), lack of counterchecking systems before preparation (CCBP) (57.8%) and after production(CCAP) (47.2%), followed by incomplete labelling (11.8%). About 54% of the pharmacy helpers hadpoor knowledge.STRATEGIES FOR CHANGE:Virtual CMEs were carried out to improve pharmacist/assistant and helpers knowledge, enforcingstandard operating procedure compliance. A continuously updated master list was displayed on the wall toease accessibility during the preparation of external galenical products. Standardised worksheets andlabels were shared among clinics in an online shared folder to enhance formulation documentation andfulfill the labeling requirements for EGP.EFFECT OF CHANGE:The errors were reduced to 7.6%. All factors showed improvement; documentation factor (25.8%), CCBP(2.3%), CCAP (0%), and labeling system (1.2%). The pharmacy helpers with good knowledge rose to69%. The total wastage cost was reduced by RM694.30.THE NEXT STEP:Remedial measures will be updated periodically and shared with other facilities.80 | Page