First Author: A.Brent UK
Co Author(s): S.W. Ch'ng L. Lebens J. Riley S. Banerjee 0 0 0 0 0 0 0 0 0
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Currently a number of intravitreal injections are given across the UK for a variety of retinal conditions. Unlike other intravitreal injections, Ocriplasmin is unique in that it has very specific properties and guidance as to its storage and delivery. This not only has implications for Ophthalmologists and theatre staff on the day of the procedure but also on the pharmacy department involved in procuring and delivering Ocriplasmin. The main aim of this project is to improve patient care by facilitating the speed of service introduction, which will reduce the time to treatment and hence the duration of patients’ ocular morbidity.
In October 2013 NICE published guidelines for Ocriplasmin use. Intravitreal Ocriplasmin provides Ophthalmologists with an alternative to Pars PlanaVitrectomy (PPV) treatment for vitreomacular adhesion (VMa) and macular holes. A quick, reliable and easy guide to set up this service would therefore be invaluable to UK Ophthalmic and pharmacy departments.
We have integrated the experience and knowledge of pharmacists, theatre staff, Ophthalmologists and pharmaceutical representatives, whom have successfully integrated an Ocriplasmin service at UHL (University Hospitals of Leicester), to provide a simple guide to aid other units through this process. We draw on not only the experience of UHL, but also from other UK departments, which have all demonstrated differing impacts and challenges depending on the current unit set up. Our guide incorporates: • Drug handling - Understanding the digital time recording device that comes with Ocriplasmin, indicating viability and what to do when this is not as expected. How and where to obtain the appropriate freezer and other necessary equipment required to handle it. • Training - We have incorporated a guide to the training programme needed for pharmacy and theatre staff regarding dry ice handling and product thawing, amongst other issues. • Drug procurement and delivery - Advice from ophthalmic pharmacists and high-cost pharmacy technicians on the potential barriers and solutions faced for this particular intravitreal injection. • Communications – Interdepartmental communication is the essence of a smooth set up. We present a few simple approaches that helped UHL to avoid common pit falls.
We have designed a simple guide to assist clinicians in setting up a service in a timely fashion, avoiding the headaches that ourselves and other trusts have encountered. We present this in the format of a poster with a step-by-step guide, including integrated flow charts and images to cover all aspects important in the implementation of a successful Ocriplasmin service.
Setting up an Ocriplasmin service in a busy ophthalmic unit has a wide variety of challenges but we believe that this simple guide will aid clinicians to do this with relative ease, speeding up the time to which patients can start receiving this treatment and hence improving the quality of patient care.