{
  "abstract": "Background Palliative care patients are often on multiple medications including controlled drugs. Medicines wastage is a significant burden including costs of supply and safe disposal, and challenges around safe storage. Patient familiarity with medications is encouraged and patients’ own controlled drugs (POCDs) are allowed to be used with in the inpatient unit setting providing they are unopened and are correctly labelled. These are stored separately to ward stock.Aim This quality improvement project sought to reduce the quantities of POCDs wasted by implementing a self-sustaining system for utilising the drugs across three wards in the hospice inpatient unit.Methods A baseline for medications destroyed by the pharmacy on each inpatient unit ward was established. Medications were split into four categories; patches, liquids, tablets/capsules and vials.Plan-Do-Study-Act cycles 1-6 included:Baseline three months of wastage by pharmacy.Discuss staff ideas, main theme – visual reminder key.Design and implement a tool, trial on first ward for a month – collect dataApply tool to other two wards – collect data.Permanent versions of the tool agreed – input from Communications team.Snapshot of wastage three months after one year to see if changes sustained.Results Waste of opioids decreased from (median per ward/per month):Patches 7 to 3Tablets 265 to 38Ampoules 120 to 56Liquid 1921g to 434 gThis was sustained for patches (2), ampoules (42), and liquids (125g) and partially sustained for tablets/capsules (81).Challenges overcome included ensuring ongoing compliance with legal compliance of CD storage, initial and sustained engagement of nursing staff, addressing worries that the quality improvement project might increase workloads and communication across the organisation. Additional data will be presented to illustrate cost-savings.Conclusion By implementing an approach that utilised visual reminders, significant reductions in waste were observed across all categories. The decrease in medication wastage was not only sustained but also demonstrated the potential for long-term cost savings and improved medication management practices.",
  "authors": [
    {
      "affiliations": [
        "St Christopher’s Hospice, London, UK"
      ],
      "name": "Emily Alcock"
    },
    {
      "affiliations": [
        "St Christopher’s Hospice, London, UK"
      ],
      "name": "Suyee Chan"
    },
    {
      "affiliations": [
        "St Christopher’s Hospice, London, UK"
      ],
      "name": "Joy Ross"
    }
  ],
  "title": "P-94 The medicine cabinet shuffle: reducing inpatient wastage by utilising patients’ own controlled drugs",
  "uid": "fb31c8dc-1954-5d52-8da9-7dcbe6fff9bb"
}