Hospitals can consider using unit dose products to improve care quality and patient safety, according to one pharmacist.
Unit dose cups sync well with barcode medication administration, which is known to improve safety, says Pradeep Thoppil, PharmD, manager of pharmacy distribution with HCA North TX – HealthTrust, a healthcare performance optimization and group purchasing organization based in Nashville. Thoppil worked in a clinical care role at an acute care hospital for most of his career.
“The unit dose cups all have barcodes associated with them. That barcode gives you the exact National Drug Code, which we utilize throughout our entire process, from receiving the product to stocking it in our automatic dispensing machines, and then all the way to the patient bedside,” Thoppil explains. “We capture that barcode, attach it to the product name, and that gives us safety steps all the way until the product is administered to the patient.”
Unit-dosed liquids also lead to exact dosing. Thoppil has seen many errors over the years with incorrect liquid doses, but the unit-dosed liquids are precise and eliminate much of the risk. “Especially now with products that come in various concentrations, a unit-dosed product gives you the exact amount needed for the patient, whereas if you’re doing this manually, there is definitely an error rate in the multiple steps required to measure the medication and provide it to the patient,” he says.
Thoppil recalls an error he witnessed that involved a bulk dry medication that had to be reconstituted as a liquid, shaken, and then poured in the correct dose. A pharmacy technician did not reconstitute the medication properly, so the concentration was incorrect.
“A child was about to get double the dose of the medication required,” Thoppil says. “If we had that product already in a unit dose project, there would be no question of the accuracy because it would already be at the proper concentration and the proper dose.”
Thoppil notes that unit dose cups also can improve efficiency because they can be loaded and stored on a unit’s dispensing system, rather than having a bulk product that must be prepared, packaged, and checked by a pharmacist before delivery to the unit.
“Especially with medications that must be delivered several times a day, relying on bulk products in a central pharmacy can delay care,” he says. “Proper dosing intervals have become more important now than when I first got out of pharmacy school 15 years ago. With some medications, you’re seeking to maintain a consistent blood level. Unit-dosed medications can help prevent the delays that can cause an unwanted drop in those levels.”
The cost difference between unit dose and bulk medications is hard to pin down because a facility must factor in the labor and supply costs of in-house measuring and repackaging a bulk product. Unit dose suppliers contend their products are cost-efficient and at least comparable to bulk products when those factors are considered.
- Pradeep Thoppil, PharmD, Manager, Pharmacy Distribution, HCA North TX – HealthTrust, Nashville, TN. Phone: (615) 344-3000.