Making more with less: use of a virtual product inventory in a Dialysis Unit.

Abstract

Background: Our Dialysis Unit has capacity for 60 onsite haemodialysis patients, requiring a significant stock of enoxaparin, iron polymaltose and iron sucrose. Storing this stock for individual patients in the medication room required approximately 0.3m3, exceeding the available space.

Objective(s): Develop and implement a Virtual Product Inventory (VPI) to minimise the required stock on hand, reducing physical storage space and risk of selection error with these high-risk medications, while maintaining PBS utilisation.

Action: Our VPI automatically deducts stock from a patient’s balance, and allows users to track dispensing episodes and prescriptions for individual patient balances. Physical stock is now stored by medication type and strength, rather than individual patient, reducing total storage space to 0.14m3, less than half the space previously required.

Evaluation: The VPI was audited over three weeks prior to full implementation. An average variance of -2% was seen between the actual and virtual balances, attributed to incorrect use of PBS stock for home training patients instead of imprest. Staff education was conducted to ensure stock was accessed correctly, and the VPI was implemented. Monthly auditing was conducted to monitor accuracy. The average variance for enoxaparin was -0.83%, and iron (polymaltose and sucrose) was -1.21%. These variances were largely attributed to dose changes not reflected immediately in the VPI and incorrect use of the stock for external patients treated in the Dialysis Unit. Balances are corrected with imprest stock, which should be accessed for these patients.

Discussion: Implementation of the VPI has been effective, accurate and widely supported by the nursing team. Feedback included increased efficiency and ease in preparing medications, and improved safety as stock is selected on strength rather than patient name. It’s now impossible for a patient to run out of stock in their “drawer”, removing the risk of delayed doses due to stock availability.