Background Recently, IV fluid distribution has been criticised in England.^1,2 Timely delivery of fluids is required if integrity of IV fluids to be maintained.

Sunderland Royal Hospital is a 1,000-bed acute unit. It distributes around 11,000 kg of IV fluids each week, to 71 different locations. Wards and departments cover 6 floors. In 2012, the time taken to deliver fluids to wards could be from 1 to 3 days. It was important to improve these times.

Purpose To re-engineer the distribution processes.

Materials and methods The IV fluids supplier was approached. A process map was developed for the whole hospital. Where poor ward storage capacity was identified, a variety of customised solutions were designed. These included creating special IV fluid trolleys to add capacity. The portering contracts were renegotiated so the pharmacy could pay staff to deliver and put away each delivery. A method of monitoring was devised that was identified items using Directive 2011/62/EU principles.³ Each individual box was given a 126 digit bar code that identified product, expiry date, batch number and unique box number. This information is read by a scanner that is used on delivery and on re-ordering, logging each box to a location, allowing mapping of any pack so that movements can be identified and stock levels adjusted. The technology also allows interrogation of data for audit purposes.

Nursing Staff acceptability was assessed using standard thematic analysis.⁴ A small focus group was used to develop and test the questionnaire, before nursing staff were surveyed. A five point scale was used which allowed a ‘no-difference’ option.

Results Table 1 shows the results measured by a variety of parameters.

Conclusions The solutions developed met ward needs, were no more expensive, and provided a more timely service.

1. Drug security: Hospitals named and shamed. 27^th January 2012 Sky News. http://news.sky.com/story/920789/drugs-security-hospitals-named-and-shamed

2. 2011 Stepping Hill Hospital poisoning incident: http://en.wikipedia.org/wiki/2011_Stepping_Hill_Hospital_poisoning_incident

3. European Directive EL (2011) 62 The ‘fruadulent medicines’ directive. Section 11. This requires manufacturers to put unique pack identification onto each and every pack http://ec.europa.eu/health/files/eudralex/vol-1/dir_2011_62/dir_2011_62_en.pdf

4. Transforming qualitative information; thematic analysis and code development. Boyatzis R. E. 1998 ISBN: 9780761909613

No conflict of interest.