OBJECTIVES: A lot of Erythropoietin (EPO) injections for weekly use were kept at the Hemodialysis Unit in order to assure the availability of drug for patients. This caused some problems such as obstruction of air flow in the refrigerator and high value of inventory holding cost. Nurses have difficulty to apply first-expire, first-out (FEFO) and medication error was also found. Therefore, EPO stock reduction was applied to resolve the problems.

METHODS: Work process of EPO management were reviewed among pharmacists, nurses, and cashier. One day ordering and dispensing was applied instead of prescribing and dispensing in advance. Nurses hand on the prescriptions to the pharmacy on the day that patients arrived at Hemodialysis Unit, except the patients who undergo hemodialysis on weekend. Stock holding of EPO were collected during November 2015 to January 2016 and were compared with the past data. In-depth interview with the attending nurses were used as qualitative outcomes. RESULTS: EPO stock keeping at Hemodialysis Unit was reduced from 114 to 13 syringes/week (88.60% reduction). EPO holding cost decreased from 178,788 to 16,744 THB/week (90.63% reduction). The patients have no need to pay for the EPO expenditure in advance, while there were no incidence of drug shortage or delay in drug administration. Nurses are more satisfied since the temperature of refrigerator were in controlled range. FEFO drug use basis can be applied effectively and medication error incidence were decreased. CONCLUSIONS: One day ordering and dispensing of EPO reduced EPO stock and led to decrease in keeping cost, easier  management and patients and staff’s satisfaction were increased.