Automated dispensing cabinet

Last updated

An automated dispensing cabinet (ADC), also called a unit-based cabinet (UBC), automated dispensing device (ADD), or automated dispensing machine (ADM) , is a computerized medicine cabinet for hospitals and healthcare settings. ADCs allow medications to be stored and dispensed near the point of care while controlling and tracking drug distribution.

Contents

Overview

A Pyxis SupplyStation at Campbell County Memorial Hospital in Gillette, Wyoming Pyxis SupplyStation automated dispensing cabinet at Campbell County Memorial Hospital in Gillette, Wyoming.jpg
A Pyxis SupplyStation at Campbell County Memorial Hospital in Gillette, Wyoming

Hospital pharmacies have provided medications for patients by filling patient-specific cassettes of unit-dose medications that were then delivered to the nursing unit and stored in medication cabinets or carts. ADCs, originally designed for hospital use, were introduced in hospitals in the 1980s and have facilitated the transition to alternative delivery models and more decentralized medication distribution systems. [2] Implementing automated dispensing cabinets as part of a decentralized or hybrid medication distribution system can improve patient safety and the accountability of the inventory, streamline certain billing processes.

However, in the 2000s, the technology began to be deployed into other care settings where medication doses were stored onsite, and higher security methods were needed to control inventory, access, and dispensing of each patient dose. Settings that now deploy ADCs include long-term care facilities, hospice, critical access hospitals, surgery centers, group homes, residential care facilities, rehab and psych environments, animal health, dental clinics, and nursing education simulation. These diverse care settings share a common need to safely store, account for, and dispense individual doses of medications, especially narcotics and high-value medications, at the point of care. [3]

ADCs track user access and dispensed medications, and their use can improve control over medication inventory. The real-time inventory reports generated by many cabinets can simplify the filling process and help the pharmacy track expired drugs. Furthermore, by restricting individual drugs – such as high-risk medications and controlled substances – to unique drawers within the cabinet, overall inventory management, patient safety, and medication security can be improved. Automated dispensing cabinets allow the pharmacy department to profile physician orders before they are dispensed. [4]

ADCs can also enable providers to record medication charges upon dispensing, reducing the billing paperwork the pharmacy is responsible for. In addition, nurses can note returned medications using the cabinets' computers, enabling direct credits to patients' accounts. Since automated cabinets can be located on the nursing unit floor, nursing have speedier access to a patient's medications. Also, shorter waiting time ensures improved patient comfort and care. [5]

Role of automated dispensing in healthcare

XT Anesthesia Workstation, an automated dispensing cabinet used in hospital operating rooms AWS-OR2.jpg
XT Anesthesia Workstation, an automated dispensing cabinet used in hospital operating rooms

Automated dispensing is a pharmacy practice in which a device dispenses medications and fills prescriptions. ADCs, which can handle many different medications, are available from a number of manufacturers such as BD, ARxIUM, and Omnicell. Though members of the pharmacy community have been utilizing automation technology since the 1980s, companies are constantly improving ADCs to meet changing needs and health standards in the industry.

Several goals can be met by implementing an automated product in a healthcare facility. Patient safety can be ensured with the use of ADC technology such as barcoding. Anesthesia ADCs in operating rooms and perioperative areas may include label printing to prevent mix-ups such as errors between morphine and hydromorphone, two different opioid analgesics that frequently get confused. [1] [2] These systems also communicate with the pharmacy and its information management system to track medications removed and support inventory replenishment. [3]

Key features

ADCs are like automated teller machines whose specific technologies such as barcode scanning and clinical decision support can improve medication safety. Some have metal locking drawers for added security and some have automated single-dose dispensing to prevent the need for a blind count each time a controlled substance is accessed. [4] Over the years, ADCs have been adapted to facilitate compliance with emerging regulatory requirements such as pharmacy review of medication orders and safe practice recommendations. [5]

ADCs incorporate advanced software and electronic interfaces to synthesize high-risk steps in the medication use process. [5] These unit-based medication repositories provide computer-controlled storage, dispensation, tracking, and documentation of medication distribution in the resident care unit. Since automated dispensing cabinets are not located in the pharmacy, they are considered "decentralized" medication distribution systems. Instead, they can be found at the point of care on the resident care unit. Tracking of the stocking and distribution process can occur by interfacing the unit with a central pharmacy computer. These cabinets can also be interfaced with other external databases such as resident profiles, the facility's admission/discharge/transfer system, and billing systems. [6]

Most ADC providers offer scalable systems since several important factors vary widely by facility such as budget, physical room size, patient population/demographics, type of healthcare facility, etc.

See also

Related Research Articles

<span class="mw-page-title-main">Pharmacy</span> Clinical health science

Pharmacy is the science and practice of discovering, producing, preparing, dispensing, reviewing and monitoring medications, aiming to ensure the safe, effective, and affordable use of medicines. It is a miscellaneous science as it links health sciences with pharmaceutical sciences and natural sciences. The professional practice is becoming more clinically oriented as most of the drugs are now manufactured by pharmaceutical industries. Based on the setting, pharmacy practice is either classified as community or institutional pharmacy. Providing direct patient care in the community of institutional pharmacies is considered clinical pharmacy.

<span class="mw-page-title-main">Prescription drug</span> Medication legally requiring a medical prescription before it can be dispensed

A prescription drug is a pharmaceutical drug that is permitted to be dispensed only to those with a medical prescription. In contrast, over-the-counter drugs can be obtained without a prescription. The reason for this difference in substance control is the potential scope of misuse, from drug abuse to practicing medicine without a license and without sufficient education. Different jurisdictions have different definitions of what constitutes a prescription drug.

Computerized physician order entry (CPOE), sometimes referred to as computerized provider order entry or computerized provider order management (CPOM), is a process of electronic entry of medical practitioner instructions for the treatment of patients under his or her care.

<span class="mw-page-title-main">Infusion pump</span> Medical device

An infusion pump infuses fluids, medication or nutrients into a patient's circulatory system. It is generally used intravenously, although subcutaneous, arterial and epidural infusions are occasionally used.

Patient safety is a discipline that emphasizes safety in health care through the prevention, reduction, reporting and analysis of error and other types of unnecessary harm that often lead to adverse patient events. The frequency and magnitude of avoidable adverse events, often known as patient safety incidents, experienced by patients was not well known until the 1990s, when multiple countries reported significant numbers of patients harmed and killed by medical errors. Recognizing that healthcare errors impact 1 in every 10 patients around the world, the World Health Organization (WHO) calls patient safety an endemic concern. Indeed, patient safety has emerged as a distinct healthcare discipline supported by an immature yet developing scientific framework. There is a significant transdisciplinary body of theoretical and research literature that informs the science of patient safety with mobile health apps being a growing area of research.

American Society of Health-System Pharmacists (ASHP) is a professional organization that represents pharmacists who serve as patient care providers in hospitals, health systems, ambulatory clinics, and other healthcare settings. The organization's nearly 58,000 members include pharmacists, student pharmacists, and pharmacy technicians. ASHP maintains a national database on U.S. drug shortages that is published on their website.

<span class="mw-page-title-main">Compounding</span> Preparation of a custom medication

In the field of pharmacy, compounding is preparation of custom medications to fit unique needs of patients that cannot be met with mass-produced products. This may be done, for example, to provide medication in a form easier for a given patient to ingest, or to avoid a non-active ingredient a patient is allergic to, or to provide an exact dose that isn't otherwise available. This kind of patient-specific compounding, according to a prescriber's specifications, is referred to as "traditional" compounding. The nature of patient need for such customization can range from absolute necessity to individual optimality to even preference.

Home automation for the elderly and disabled focuses on making it possible for older adults and people with disabilities to remain at home, safe and comfortable. Home automation is becoming a viable option for older adults and people with disabilities who would prefer to stay in the comfort of their homes rather than move to a healthcare facility. This field uses much of the same technology and equipment as home automation for security, entertainment, and energy conservation but tailors it towards old people and people with disabilities.

<span class="mw-page-title-main">Pharmacy (shop)</span> Shop which provides pharmaceutical drugs

A pharmacy is a retail shop which provides pharmaceutical drugs, among other products. At the pharmacy, a pharmacist oversees the fulfillment of medical prescriptions and is available to counsel patients about prescription and over-the-counter drugs or about health problems and wellness issues. A typical pharmacy would be in the commercial area of a community.

Health information technology (HIT) is health technology, particularly information technology, applied to health and health care. It supports health information management across computerized systems and the secure exchange of health information between consumers, providers, payers, and quality monitors. Based on a 2008 report on a small series of studies conducted at four sites that provide ambulatory care – three U.S. medical centers and one in the Netherlands, the use of electronic health records (EHRs) was viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system.

Electronic prescription is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, or nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.

<span class="mw-page-title-main">Bar code medication administration</span>

Bar code medication administration (BCMA) is a bar code system designed by Glenna Sue Kinnick to prevent medication errors in healthcare settings and to improve the quality and safety of medication administration. The overall goals of BCMA are to improve accuracy, prevent errors, and generate online records of medication administration.

<span class="mw-page-title-main">Remote dispensing</span>

Remote dispensing is used in health care environments to describe the use of automated systems to dispense prescription medications without an on-site pharmacist. This practice is most common in long-term care facilities and correctional institutions that do not find it practical to operate a full-service in-house pharmacy.

Pharmacy automation involves the mechanical processes of handling and distributing medications. Any pharmacy task may be involved, including counting small objects ; measuring and mixing powders and liquids for compounding; tracking and updating customer information in databases ; and inventory management. This article focuses on the changes that have taken place in the local, or community pharmacy since the 1960s.

<span class="mw-page-title-main">Drug packaging</span> Packaging for pharmaceutical preparations

Pharmaceutical packaging is the packages and the packaging processes for pharmaceutical preparations. It involves all of the operations from production through drug distribution channels to the end consumer.

<span class="mw-page-title-main">Healthcare in Belgium</span> Overview of the health care system in Belgium

Healthcare in Belgium is composed of three parts. Firstly there is a primarily publicly funded healthcare and social security service run by the federal government, which organises and regulates healthcare; independent private/public practitioners, university/semi-private hospitals and care institutions. There are a few private hospitals. Secondly is the insurance coverage provided for patients. Finally, industry coverage; which covers the production and distribution of healthcare products for research and development. The primary aspect of this research is done in universities and hospitals.

<span class="mw-page-title-main">Telepharmacy</span> Pharmacy care by telecommunication

Telepharmacy is the delivery of pharmaceutical care via telecommunications to patients in locations where they may not have direct contact with a pharmacist. It is an instance of the wider phenomenon of telemedicine, as implemented in the field of pharmacy. Telepharmacy services include drug therapy monitoring, patient counseling, prior authorization and refill authorization for prescription drugs, and monitoring of formulary compliance with the aid of teleconferencing or videoconferencing. Remote dispensing of medications by automated packaging and labeling systems can also be thought of as an instance of telepharmacy. Telepharmacy services can be delivered at retail pharmacy sites or through hospitals, nursing homes, or other medical care facilities.

Pyxis Corporation was a San Diego company co-founded by Ronald R. Taylor and investor Tim Wollaeger in 1987. The company is the first to develop MedStation products in 1990 and is also a market leader for automated medication management, developing an automated dispensing cabinet under the name Pyxis.

Omnicell, Inc. is an American multinational healthcare technology company headquartered in Mountain View, California. It manufactures automated systems for medication management in hospitals and other healthcare settings, and medication adherence packaging and patient engagement software used by retail pharmacies. Its products are sold under the brand names Omnicell and EnlivenHealth.

Autonomous pharmacy is an approach to medication management that seeks to create a more automated and data-driven process for medication inventory and dispensing. The main concept behind autonomous pharmacy is to use technology in place of manual medication processes in order to help healthcare providers reduce medication errors, decrease costs and save staff time. Autonomous pharmacy may use a combination of hardware, software and technology-enabled services to allow pharmacists to more effectively manage medication dispersal.

References

  1. Guidance on the Interdisciplinary Safe Use of Automated Dispensing Cabinets (PDF) (Report). Institute for Safe Medication Practices. 2008.
  2. Grissinger, Matthew (2018). "Key Vulnerabilities in the Surgical Environment: Container Mix-Ups And Syringe Swaps". P & T: A Peer-Reviewed Journal for Formulary Management. 43 (3): 129–167. PMC   5821235 . PMID   29491691.
  3. Meyer, Tricia A.; McAllister, Russell K. "Strategies for Optimizing OR Drug Safety". Pharmacypracticenews. Retrieved 19 March 2018.
  4. "ASHP Guidelines on Preventing Diversion of Controlled Substances". ashp.org.
  5. 1 2 Olson, Barbara L. (10 July 2009). "Automated Dispensing Cabinets: Getting It Right in the Age of Automation" . Topics in Advanced Practice Nursing eJournal. Medscape. 9 (3).
  6. "Automated Medication Dispensing Cabinets". Technology for Long-Term Care. 25 May 2010. Archived from the original on 13 January 2011. Retrieved 3 June 2010.