Medical center turns to automated drug dispensing

Pharmacists have most to learn about system

In an effort to reduce medical errors and comply with patient safety standards, one Georgia medical center has turned to automation. Floyd Medical Center (FMC) in Rome, however, isn’t just automating one part of the drug dispensing process. It is installing an entire new pharmacy, supply, and operating room system.

FMC plans to spend $3.4 million over the next five years to bring the system to the hospital. Components of the system being installed include a unit-dose center in which every dose is released individually and recorded automatically. The system also has an anesthesia workstation, an automated, mobile system for storing medications and supplies in the operating room, and a digital physician order management system that communicates orders from nursing stations to the hospital pharmacy. Omnicell of Palo Alto, CA, provided the system.

Floyd Medical Center selected the system for many reasons, including patient safety, customer satisfaction, improved use of nurses’ time, improved documentation, and accurate charging and compliance. FMC planned to install the system over a three-month period.

The system consists of computerized drug and supply cabinets that will be located in every patient care area of the hospital. Each of the computerized cabinets will be equipped with a code-protected computer that will give patient care professionals access to patient prescriptions or other medical items.

"Nurses will be able to access medications after a pharmacist has reviewed and verified the order," said Robert Purcell, PharmD, FMC’s pharmacy director.

Each drug or supply item will contain a bar code that must be scanned before it is given to the patient. In addition, patients at FMC will be assigned a bar code on the bracelets they receive upon admission. The system matches the patient bar codes with the supply and prescription bar codes to ensure that patients are receiving the correct medications.

All the systems at FMC will also be equipped with color touch screens and web browsers with access to the Clinical Pharmacology drug information database. For example, clinicians will be able to view information, such as drug interactions, on the screen installed in the cabinets before they withdraw and administer medications.

Once the nurse or physician selects the drug or supply that is to be dispensed, the drawer containing the appropriate drug or supply will open automatically, and a flashing light will direct the clinician to the selected item. The cabinet will dispense only one dose or item at a time, and once the medicine or supply item is removed, the computer adjusts its inventory list to reflect the change.

The system is also equipped with lights that direct the nurse to the correct drug, Purcell says. "If a drug is selected that has not been approved for the patient or if the nurse selects the incorrect drug, an alarm will sound and a record of transaction will be created, documenting the incident."

Before using the system, pharmacy personnel have to learn procedures to stock, maintain, and input information into the system, Purcell explains. "For pharmacists and pharmacy technicians, the training has been very involved," he says, "However, it is not difficult to learn."

Nurse training is less involved. They have been taught how to access medications and what to do in the event that discrepancies are noted, Purcell says.

The new system will expedite the dispensation of medicines and eliminate time spent on nursing units accounting for drugs and supplies used on each shift, he says. "We want to get 85% to 90% of the drugs out there on the nursing units instead of us issuing drugs to patients individually." The cabinets will be restocked daily, he adds.

Another benefit to the system is real-time charging, which means that patient accounts are charged for drugs or supplies at the time they are dispensed. "It creates a record of everything that is done," Purcell says.

In addition, the system allows the pharmacy or materials management department to track usage of medicines and supplies. The reporting capability helps the medical center analyze pharmaceutical and supply usage and make decisions on future purchases and inventory levels.