Getting it Right - To enhance the eye drop medication safety in Clinic

1. Angelina Mei Ha Tong
2. Yuen Yee Lee
3. Ingrid Siew Yee Wong
4. Yin Yling Wong
5. Christina Yee Sheung Tsang

1. Eye clinic, Alice Ho Miu Ling Nethersole Hospital, Tai Po, Hong Kong
2. Eye clinic, Prince of Wales Hospital, Tai Po, Hong Kong

Purpose:
1) To improve the safety of administration of dilating eye drops in eye clinic
2) To prevent inadvertent prescription of dilating eye drop with " Known Drug Allergy"
3) Proper documentation of the drug prescription and administration

Methods:
1) Review recent drug incident
2) Collect opinions from staff for the improvement program
3) Revise the flow of dilating eye drugs including prescription and administration
4) Develop departmental protocal for prescription and administration of dilating eye drops
5) Introduce the changes to staff and implement the new workflow
6) Perform audit to ensure the compliance of the protocol

Results:
1) Doctor would prescribe the dilating eye drops in accordance with the protocol.
2) All staff is able to check the eye drugs against the patient's name, ID, correct eye, prescription of drug for dilatation and allergy history before instillation
3) All patient requiring dilatation with know allergy to Mydrin-P will be substituted by 1% Cyclopentolate. Those patients without known allergy to Mydrin-P will stick to the department protocol for dilating eye drops as usual practice.
4) The procedure guideline and protocol for handling patient with drug allergy had been developed. Proper documentation of drug allergy history is maintained.

Conclusions:
There are over 100 patients who require dilating eye drop in each clinic session. Giving dilating eye drops to patient is a high volume medication procedure in clinic. It is a big challenge for doctors, nurses and supporting staffs to comply 3 check 5 right and maintain a proper documentation on the use of dilating eye drops. After the implementation of such new protocol and workflow, the medication administration principle can be applied in clinic setting.