Another Form? Evaluating The Intravitreal Administration Chart (ivac) And Whether It Improved Documented Treatment Plans.

• By: HOANG, Naythen (Royal Brisbane and Women's Hospital Pharmacy Department, Australia)
• Co-author(s): Mr Naythen Hoang (Royal Brisbane and Women's Hospital Pharmacy Department, Herston, QLD, 4006, Australia)
  
• Abstract:

  Background:
  In our metropolitan ophthalmology clinic, intravitreal injection (IVI) plans were documented in the outpatient progress notes (OPN). To ensure the correct drug, frequency, and eye(s) were injected, a second source of documentation on a booking form (BF) was required to clarify the plan. However, both the OPN and BF often contained incomplete or missing information about IVI plans which was a risk to patient safety. It was identified that a new more structured documentation process and form was required.
  
  Objective(s):
  To develop an Intravitreal Injection Administration Chart (IVAC) to replace the BF and evaluate
  whether it improved the clarity and documentation of IVI treatment plans.
  
  Action (Method):
  In consultation with the multidisciplinary ophthalmology team, a local medicines advisory group, and local forms committee, a new IVAC form was developed in July 2021 to replace the BF. OPN were still required to be used in addition to the new IVAC.
  
  To evaluate, a retrospective audit of patients who received an IVI before (1/1/2021-9/7/2021) and after (10/7/2021-1/1/2022) the implementation of the IVAC was conducted. Additionally, ophthalmology clinical staff completed a survey to determine the acceptability of the IVAC.
  
  Evaluation:
  351 OPNs were extracted during the study period, with 83% (291/351) of these having incomplete IVI orders (134 pre- and 157 post-implementation). Of the 134 OPNs pre-, only 58 (43%) had an accompanying BF. Of the 157 OPNs post-, 151 (96%) had an accompanying IVAC. From the survey, 90% (18/20) of clinical staff stated they preferred the IVAC over the BF.
  
  Discussion:
  The form had great uptake by ophthalmologists, with almost all OPNs in the post period had accompanying IVACs. This represents a reduction in the likelihood of the incorrect IVI being ordered or administered, ultimately improving patient safety. As well as being safer, the form was well accepted by staff.