Authors (including presenting author) :
Hung SY, Cheung PH, Cheung YHK, Fan SYC, Leung WM, Wong MYM, Wong MSM
Affiliation :
Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster
Introduction :
Cold chain is a system to ensure refrigerated medicines are stored, handled and
transported at the recommended temperature range of +2°C to +8°C. Standard cold chain management can ensure the quality of refrigerated medicines and the safety of patients.
From 2017-2021, in the General Out-patient Clinics (GOPC) of Hong Kong East Cluster (HKEC), there were 6 incidents related to cold chain failure, and the temperature of pharmaceutical refrigerators in treatment rooms was out of the recommended range. Although the fridge alarm system was activated, for which on-duty staff could take immediate follow-up actions, 3 out of the 6 cases occurred during midnight or early morning when the clinic did not have any on-duty staff. These cold chain failure incidents could only be followed up after clinic staff arrived.
Pharmaceutical refrigerators inside the Pharmacy were connected to a 24-hour remote monitoring system. Designated pharmacy staff would take appropriate follow-up action when they received temperature outrange signals off-site. However, to minimize storing fridged medicines in the pharmaceutical fridge inside clinic’s treatment room after clinic closed, storage capacity of refrigerators inside the Pharmacy should be increased.
Objectives :
1.Review and standardize cold chain management in GOPCs, HKEC
2.Ensure refrigerated medicines can be stored and maintained according to the standard cold chain management
Methodology :
1.Reviewed cold chain management with a contingency plan in clinics, standardized the workflow
2.Designed a simple cold chain contingency management flowchart in Chinese, posted up near the pharmaceutical refrigerators in treatment rooms and easily reached by all staff. Briefing was conducted to staff.
3.In Nov 2021, conducted a site visit to clinics’ pharmacies to reconstruct cabinets, redesign shelving system; purchased and installed larger size pharmaceutical refrigerators in Pharmacies
Result & Outcome :
Since Oct 2022, all pharmaceutical refrigerators in pharmacies of GOPCs of HKEC had sufficient capacity to store refrigerated medicines for the clinics. This allowed minimum refrigerated medicines stored in treatment rooms at clinic sessions according to the estimated number of injections daily. The refrigerated medicines would return to pharmacies and be stored in the pharmaceutical refrigerators with a 24-hour remote monitoring system after the daily clinic session ended.
Proper cold chain management is important to ensure the quality of refrigerated medicines and patient safety.
