A friend from Talyst stopped by the pharmacy and spent the greater part of Monday afternoon and Tuesday morning taking a look at what it means to work in an acute care hospital pharmacy. We have several pieces of Talyst automation and technology in our pharmacy and he was interested in how we used it and how it fit into the general scheme of things. As we roamed the pharmacy, I began describing our Pyxis system, how we handle our replenishment, how we put our order away, how we package bulk medications, how we barcode syringes, how we handle an IV batch, how we handle infusions for our smart pumps, and so on and so forth ad infinitum. It was a good exercise for me as it often improves my understanding of something when I try to explain it to someone else.
(more…)
Category: Automation
-
Pharmacy workflow on life support
-
Pharmacy technology – Automated dispensing
PROmanager-Rx is an automated system from McKesson designed for dispensing unit-dosed oral solids. PROmanager-Rx has a 12,000-dose capacity and uses a conveyor system and bar-code scanner to fill orders generated through the pharmacy information system.
The system automates storage, dispensing, restocking, and various inventory management functions via the McKesson Connect-Rx software platform. And of course the system interfaces with McKesson’s pharmaceutical distribution system.
According to the McKesson product brochure:
The PROmanager-Rxâ„¢ system helps hospital pharmacies get the most out of manufacturer packaged oral solid medications. And relieves the burden of medication packaging.
It’s the only fully automated system that directly stores and dispenses pre-packaged oral solids. PROmanager-Rx is ideal for patient-centric filling. Bar-code-driven robotics scan every dose for the greatest possible safety and accuracy.
Pharmacists are freed from packaging and dispensing activities so they can play more integral roles on the clinical care team. Bar-code scanning also simplifies tasks such as managing returns, expired meds, and overall inventory.
-
Medicated patch slips into wrong ADC pocket
Hospital Pharmacy: “During the process of with drawing a patient’s nicotine patch from an automated dispensing cabinet (ADC), a carousel pocket opened to reveal 2 nicotine patches and 1 fentaNYL 50 mcg/hr patch. The nurse using the ADC immediately called the pharmacy to report the discrepancy. The pharmacy investigated and found that it was not a dispensing error. Both patches (nicotine and fentaNYL) were stored in the same medication carousel, and the fentaNYL patch slipped over the top of one pocket and into another pocket that contained nicotine patches. Generally, the hospital reserved ADC carousel pockets for controlled substances, but there was a history of pilferage of the nicotine patches when stored in matrix drawers. To deter pilferage, the pharmacy began stocking them in secure carousel pockets with the tracking feature on to count the product. FentaNYL was in a nearby pocket by itself, but when the carousel turned, patches sticking up from the fentaNYL pocket were caught and dragged to another pocket that housed nicotine patches.” - This type of occurrence is more common than you might think. To prevent this type of thing from happening, many hospitals will utilize a system similar to the Pyxis CUBIE system. Pyxis CUBIE pockets are small containers with a clear plastic lid. The lid remains closed until that medication is accessed via the Pyxis medication terminal. This prevents items from jumping to another location.
-
Panasonic robot drug dispenser
Engadget.com: “Panasonic isn’t the first company to turn to robots as a means for dispensing drugs, but it looks like it’s set to become one of the bigger players in the still fledgling field, with it announcing today that it’s developing a robot that it hopes will rake it about 30 billion yen (or $315 million) by 2016. Unfortunately, Panasonic isn’t quite ready to actually show off the robot just yet, but it says it could be making the rounds at some Japanese hospitals by next March, and head into the United States and Europe sometime after that. It’s also not ready to do much talking about specifics, with it only going so far as to say that it “does not look humanoid” but rather looks like “a cabinet with lots of small drawers”, and that it’ll be able to store medical data for each patient and sort out prescriptions for up to 400 patients in about two hours. That cabinet won’t come cheap though, with Panasonic estimating that it’ll cost “several tens of millions of yen,” or hundreds of thousands of dollars.” – When I was a pharmacy student at UCSF there was an automated drug dispensing robot roaming the halls. The robot was affectionately called Elvis. It was pretty cool to see him roll out of the elevator and down the hall to the nursing station, but he was nothing like ASIMO.
-
Beyond patient safety with technology and automation
I had reason to do some thinking about healthcare automation over the weekend, and after much thought decided that healthcare, specifically pharmacy, was a little strange in several ways. As an industry, healthcare rarely looks beyond patient safety when talking about technology and automation. Let’s face it, patient safety is the rally cry for any department in need of a jumpstart to complete a project that has stalled for one reason or another. Unfortunately the investment of time, energy and capital resources typically stops immediately after implementation secondary to meeting the patient safety goal. However, this model seldom allows for technology and automation to be taken to the next logical step.
(more…) -
Use AutoPharm Remote Ordering to restock your clean room.
Prior to the days of a clean room, most pharmacies had a designated area with one or move laminar flow hoods where they compounded intravenous (IV) medications. For lack of a better term this area was cleverly called the “IV Room”. The laminar flow hoods created a sterile work environment from which the pharmacy technicians could work. It was not uncommon for anyone making an IV preparation to simply leave the “IV Room” and wonder around the pharmacy looking for supplies when they ran short.
(more…) -
ISMP launches first self assessment of ADC safety
ISMP.org: “More than 80% of US hospitals have implemented automated dispensing cabinets (ADCs) as an important part of their drug distribution system, making the evaluation of practices surrounding this technology an essential step in ensuring patient safety. To help meet healthcare organizations’ growing need for assistance in this area, ISMP has introduced the first Medication Safety Self Assessment for Automated Dispensing Cabinets. The assessment contains 12 core elements that support the safe use of ADCs, which are based on guidelines developed by a national forum convened by ISMP comprising practitioners and vendors with expertise in the safe use of ADCs.** Many of the core elements represent system improvements and safeguards that ISMP has recommended in response to analysis of medication errors and problems identified during onsite ISMP consultations with hospitals. ” – ISMP offers some great resources and their self assessments are are a good way to see exactly where you stand against their “standards”. I would encourage every acute care facility using ADCs to complete the survey and submit their data to ISMP, confidentially of course.
-
Visit to Northwestern Memorial Hospital in Chicago
During my recent trip back east I had the opportunity to drop in on the inpatient pharmacy at Northwestern Memorial Hospital in downtown Chicago. The reason for the visit was simple. I was already in Chicago for the ASHP Summer Meeting and Northwestern utilizes some of the same pharmacy automation as Kaweah Delta. One would think that the same automation would equal the same procedures, but nothing could be further from the truth. This is one of the fundamental problems with hospital pharmacy in general. Lack of standardization equates to the inability to share information across multiple facilities. Best practice is elusive when talking about automation in pharmacy.
(more…) -
Thinking about a better Automated Dispensing Unit (ADU)
Automated Dispensing Units (ADUs), also referred to as Automated Dispensing Cabinets (ADCs), are nothing new to hospital pharmacy. Over 80% of hospital pharmacies use ADUs. The most common is a product from Cardinal called Pyxis MedStation. Others include Omnicell SinglePointe, McKessen AutoDose-Rx and medDISPENSE (part of Emerson Electric Co.). Currently Pyxis is the clear front runner, and for good reason. They offer a great product.
(more…)