Category: Professional Posters
Purpose: Pharmacists are responsible for verifying the prescription of intravenous chemotherapy and for the management of accurate compounding sterile preparations. However, pharmacists and staffs are burdened with increased in the number of cancer patients and unpredictable transmitted intravenous chemotherapy in routine work. Therefore, we developed a program to calculate the concentration automatically during the verifying prescription to reduce the workload burden.
Methods: We conducted before and after study to assess the effects of computerized intravenous chemotherapy concentration calculation program on duty time. It was established that intravenous chemotherapy were required fluid dilution and the dilution concentration range was designed in calculation program (intervention). If chemotherapy order concentration was exceeded, it was configured to be displayed as a check target on the screen in the program. The data in this study prospectively was gathered from March and August 2018 (for 16 weeks, before 8 weeks and after 8 weeks, except May and June when developing program period). It was consisted of the total working hours of per week (A) and time of monitoring and preparation of intravenous chemotherapy per week (preparation work time, B). The outcome was presented by percentage of B (minutes) divide A (minutes) and interrupted time series and segmented regression model were used for statistical analysis. The software package Statistical Analysis System version 9.4 (SAS Institute, Cary, North Carolina) and Office Excel 2010 were used for all statistical analysis.
Results: The study findings showed that pre-intervention preparation work time (β0) was approximately 1.09 percent, and the preparation work time trend (β1) increased slightly by about 0.02 percent, but this was not statistically significant (p=0.2801). Since the implementation of the program (intervention, β2), the preparation working time has decreased by about 0.66 percent and has been statistically significant (p<0.0001). The preparation working time trend for time after-intervention (β3) was a slight increase of 0.02 percent, but not statistically significant change (p=0.2574). For the most parsimonious segmented regression model, which removes non-statistically significant variables from full segmented regression, the implementation of the program (intervention, β2) has decreased by approximately 0.4 percent which means about 35.41 percent reduction in preparation working time per working week (p<0.0001).
Conclusion: The computerized intravenous chemotherapy concentration calculation program has led to a reduction in the preparation work time. This study has limitations that the results cannot be generalized because seasonality was not identified due to the short collection data period and the workflow of each medical institution is different. The program also needs regular management and updates of new chemotherapy on the market by pharmacists. However, application of automated program suggests that it can reduce the burden of pharmacists’ work and further prevent medication errors.