870

Abstract

Learning Objectives: Four factor prothrombin complex concentrate (4F-PCC), KCentra™, recently replaced three factor PCC (3F-PCC), Bebulin® VH, as the formulary PCC at Grady Health System in Atlanta, GA. With this change in product, the department dispensing the PCC and processing the order changed from blood management services to pharmacy services. Methods:This study is a single center, retrospective chart review of adult patients with an order for Bebu-lin® VH (5/1/2013 to 9/30/2013) or KCentra™ (11/1/2013 to 3/31/2014). The purpose of this study is to determine if pharmacy management of the verification and compounding process for PCC created a positive impact on the time from order entry to drug administration. Secondary endpoints include characterization of prescribing patterns and dosing, among other endpoints. The Mann-Whitney U and Chi-squared statistical tests were used for comparisons between the KCen-tra™ and Bebulin® VH cohorts. Descriptive and inferential statistics were used to draw results from secondary objectives. Results: Thirty-two orders were reviewed in the Bebulin® VH cohort and 20 orders were reviewed in the KCentra™ cohort. Turn-around time from order entry to drug administration was 71 minutes for the KCentra™ cohort compared to 151 minutes for the Bebulin® VH cohort (p=0.001). The emergency department service was the most common service placing the initial order for PCC in both groups. The most common indication for treatment in both groups was warfarin-related bleeding, 81% (26/32) in the Bebulin® VH group and 63% (12/19) in the KCentra™ group. KCentra™ dosing from the initial order was based on order set parameters in 58.3% (7/12) of respective warfarin-related bleeding cases. Conclusions: Adoption of pharmacy verification and processing for PCC decreased the time from order placement to administration at the institution being studied. Continued multidisciplinary education and process improvement initiatives are necessary, and currently underway, to meet goal order entry to administration time of less than 30 minutes.