Authors (including presenting author) :
Chan HL, Leung MW, Ho SM
Affiliation :
Department of Medicine & Geriatrics, United Christian Hospital
Introduction :
Iron infusion, traditionally administered mainly in ambulatory settings, has seen a significant increase in inpatient use contributed by the need for faster correction of anemia and reduced reliance on blood transfusions. In 2023, the hospital dispensed 1,530 doses of iron infusion, with usage surging by 25% in 2024. Administration of iron infusion requires close monitoring due to potential lethal hypersensitivity reactions such as hypotension. Challenges in inpatient care include unfamiliarity with ambulatory protocols, lack of standardized guidelines, and hesitation among nurses in managing iron infusion stemming from unclear documentation procedures. To address these issues and enhance clinical safety, a standardized record of vital signs for iron infusion was designed and adopted.
Objectives :
To enhance patient safety and ensure accurate and clear documentation of vital signs when patients received iron infusion.
Methodology :
Pre-printed labels for vital signs record were prepared after internal discussion, together with consultation of ward pharmacist and literature reviews. A 3-month pilot was conducted in the acute medical ward (12B) from February to April 2024, targeting all patients receiving iron infusion. Training session was held for all nursing staff to introduce the label and potential side effects associated with iron infusion. The labels were affixed to patient progress sheet. Direct observation was done by a link nurse to explore the application of pre-printed labels throughout the pilot. Feedback was gathered through individual interviews with 20 medical and nursing staff concerning the appropriateness and acceptability of the label in the daily operation.
Result & Outcome :
Over 30 patients received iron infusion during the pilot, with a 100% application rate of the pre-printed labels. Nurses reported that the user-friendly design reduced time searching for guidelines and improved monitoring efficiency. Standardized documentation enhanced communication between healthcare workers and minimized disruptions to routine observations. Awareness of allergic reactions was increased, boosting nurses’ confidence in managing patients. Medical officers found the records clear and useful for patient management. The pilot’s success led to the continued adoption of the labels across the ward.
Standardized monitoring and documentation improved safety and efficiency in managing iron infusion patients. Miscommunication was minimized, and clinical safety was enhanced by reinforcing nursing staff knowledge and confidence. Further refinements, such as incorporating color-coded designs, are recommended for future improvements.
