Managing amoxicillin-clavulanic acid 1.2 gram in a North West public hospital : a supply chain analysis / Liezel van Geems

• Main Author: Van Geems, Liezel
• Language: en
• Published: 2016
• Subjects: Supply chain; Inventory management; Stock control; Procurement; Amoxicillin-clavulanic acid 1.2 gram; Medical unit; Public hospital; Professional nurse
• Online Access: http://hdl.handle.net/10394/15682

Professional nurses and their patients are directly influenced by insufficient medication, causing a decrease in the quality of care, delays in hospitalisation and it might lead to resistance. In some cases professional nurses have to leave the unit in search of medicine. Amoxicillin-clavulanic acid 1.2 gram for intravenous administration is prescribed to the majority of patients in the medical units in public South African hospitals. Yet there are intermitted insufficient stock levels and challenged inventory systems for amoxicillin-clavulanic acid 1.2 gram in some public hospitals. This fact is positioned against the background of a South African health system that has undergone major changes since the fall of Apartheid in 1994 and amidst major positive changes, is still challenged by overburdened hospital admissions and a quadruple disease burden. The aim of this research was to enhance optimal levels of amoxicillin-clavulanic acid 1.2 gram in medical units in public hospitals to ensure sufficient stock levels and timeous administration. The aim was achieved by identifying and describing the current supply chain of intravenous amoxicillin-clavulanic acid 1.2 gram in two medical units in a district (level 2) public hospital in the North West Province (from here referred only as North West) by identifying inefficiencies in the current supply chain and to formulate recommendations for management to enhance the supply chain of intravenous amoxicillin-clavulanic acid 1.2 gram to medical units in public hospitals. An exploratory case study approach was followed to explain the supply chain of amoxicillin-clavulanic acid 1.2 gram by utilising a qualitative, descriptive, explorative and contextual design. A case study approach was chosen as it examined single units within the context of real life as environment, which in this case were medical units in a level two public hospital, North West. The case selection was motivated and described, followed by case records of policies and standard operational procedures. Field participants included all levels of nurses (professional, enrolled and auxiliary) in medical male and female units on day and night duty, and the head of pharmacy [n=8]. Non-probable, purposive sampling was conducted according to inclusion criteria after all levels of ethical clearance and consent were granted. Three semi-structured individual interviews followed, after which two focus groups were conducted. Thematic analysis of transcriptions was done, followed by an analysis of case records regarding where after all results were integrated. Results indicated complex organisational, unit-specific and behavioural challenges that impact on the supply chain management of amoxicillin-clavulanic acid 1.2 gram and insufficient stock levels are predominantly positioned within retailer and customer aspects of the supply chain. Despite well-formulated standard operational procedures, the realisation thereof lacks, implicating a greater need for managerial control. Recommendations were formulated for management to enhance the supply chain of amoxicillin-clavulanic acid 1.2 gram in medical units in public South African hospitals integrated with good pharmacy practices. The close collaboration, mutual respect and effective communication between health professionals in the multi-professional team are reiterated. === MCur, North-West University, Potchefstroom Campus, 2015