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Introduction
▶Automation
any technology , machine or device linked to or
controlled by a computer and used to do work
Advantages:
▶ Improve efficiency( Reduce pharmacy staff and work load)
▶ Improve accuracy, reduce errors
▶ Improve documentation
▶ Authorized access only, enhance security
▶ Reduce job stress and staff turnover
▶ Shorten med pass time for nurses/ caregivers
Disadvantages:
▶ Additional training and technical help
▶ Downtime, system failure and inflexibility
▶ Cost and space issues
Medication use process
Consists of five domains:
1. Purchasing/ inventory management
2. Prescribing/medication determination
3. Medication preperation, dispensing, and counseling
4. Medication administration
5. Patient monitoring /assessment
Technologies And Automated Devices
Applied Throughout The Medication –Use
Process
Prescribing
⚫ Clinical descion support soft ware
⚫ Computerized prescriber order entry
Dispensing
⚫ Centrilized robotic dispensing technology
⚫ Centralized narcotic dispensing and inventory tracking devices
⚫ Decentrilized automated dispensing devices
⚫ Unit dose medication repacking systems
Administration
⚫ Bar code medication administration technology
Monitoring
⚫ Electronic clinical documentation systems
Unit Dose System
▶ Medication cassettes
Unit Dose Systems
Advantages:
▶ Improve accuracy, less errors
▶ Easy to track usage
▶ Less nursing time at dispensing
▶ Less wastage, savings to facility and patient
Disadvantage:
▶ More pharmacy processing time and equipment cost
▶ Requires more storage space and cassette cost
▶ No cost savings to pharmacy
▶ Limit nursing processing and checking ability
Decentralized Automated Dispensing
Devices
▶ unit base dispensing cabnits, are secure storage
cabinets capable of handling most unit dose and some
bulk (multiple –dose) medications.
Automated dispensing systems
▶ are drug storage devices or cabinets that electronically
dispense medications in a controlled fashion and track
medication use.
Small systems:
▶ Pyxis medstation
▶ Baxter ATC
▶ Script-pro 200
Larger systems:
▶ Baker cells
▶ Baxter international
The McLaughlin dispensing system
▶ Physicians’ orders are entered into the pharmacy computer and then
transferred to the Medstation where patient profiles are displayed to the
nurse who accesses the medications for verified orders.
▶ Each nurse is provided with a password that must be used to access the
Medstation.
▶ Currently ,nurses select the patient required and then select the drug
required from a list of all drugs available in the unit. The units can also be
run in ‘profile mode’ where the pharmacist reviews medication orders and
profiles a list of medications currently prescribed for the patient and
nurses then select from that list.
The Pyxis Medstation, Medstation Rx, and
Medstation Rx 1000
▶ Pharmacists or technicians keep these units loaded
with medication. Charges are made automatically for
drugs dispensed by the unit.
▶ In pharmacy system
▶ Counts a 30-count vial in 3-5 seconds
▶ Option to use software that dispenses medication
after a prescription is canned
The medication administration record
(MAR):
Pharmacist
Order Fulfillment Final scan
Review &
& Verification
Verification
Bar Code Medication Administration (BCMA
A. Patient name
B. Medication name
and strengths
C. Time of
administration
D. Bar code for
bedside scanning
At bed side
Disadvantage
▶ Bar codes mismatch with drug, dose and patient at
times
▶ Bar code sometimes function erroneously
▶ Unable to scan bar codes properly at times
▶ Unreadable bar codes
▶ Time consuming