DD-004 Optimisation of storage and unit dose dispensing circuit

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Abstract

Background

The unit dose dispensing of medication is a key activity in all hospital pharmacy services. On creating a new hospital, the settings for a semi-automatic Kardex verticals (KV) system for dispensing and drug storage were based on previous consumption of a hospital with less activity, needing to be upgraded.

Purpose

Identification of drugs required by the unit dose dispensing circuit, external to KV, to optimise the efficiency of human resources for unit dose drug preparation and dispensing, reducing errors and improving patient safety in hospital.

Material and methods

A retrospective observational study was conducted in a tertiary hospital. A database was designed with the following parameters: list of KV external drugs, frequency of these medications in unit dose circuit, their location and reasons for not being located in KV.

Results

The presentations with the highest incidence of appearance as external products were: risperidone 6 mg tablets (9.29%), clotiapine 40 mg tablets (7.81%), progesterone 200 mg capsules (7.25%), dexchlorpheniramine 2 mg/5 mL solution (7.06%), cinacalcet 30 mg tablets (3.53%), calcium carbonate/cholecalciferol (3.53%), apixaban 5 mg tablets (3.35%), droperidol 2.5 mg amp/vial (2.42%), paromomycin 125 mg/5 mL (2.23%), chlorpromazine 25 mg tablets (2.23%), ketamine vial (2.23%), baclofen 25 mg tablets (1.86%), ticagrelor 90 mg tablets (1.86%), fosfomycin 3 g sachets (1.67%) and clotrimazole 1% ointment (1.67%). Locations of the external presentations were: low consumption shelf (3.41%), outpatient area (7.95%), magistral formulae (1.14%), semi-automatic drug dispensing and storage system Kardex Horizontal (60.23%), non-hospital pharmaceutical guide shelf (11.36%), paediatric products (7.95%) and restricted drugs (7.95%). The causes of not located in KV were: low consumption by the unit dose dispensing circuit (38.63%), low consumption by all hospital dispensing circuits (3.41%), special monitored dispensation (1.14%), magistral formulae (1.14%), multidose presentations (2.27%), non-hospital pharmaceutical guide (11.36%), outpatient dispensation (7.95%), required for hospital unit order dispensation (17.05%), paediatric presentations (7.95%), restricted use (7.95%) and recent inclusion in the hospital pharmaceutical guide (1.14%).

Conclusion

After years in operation, this current study detected opportunities for improvement, proposing the inclusion in KV of: risperidone 6 mg, clotiapine 40 mg, progesterone 200 mg, calcium carbonate/cholecalciferol, baclofen 25 mg and fosfomycin 3 g. With this improvement, we intend to increase the work speed and enhance the distribution of staff time, reducing errors in unit dose dispensing, thus increasing the productivity of service and patient safety.

References and/or acknowledgements

Juvany Roig R, et al. Optimización (...) Kardex. Farm Hosp2007;31:38–42.

References and/or acknowledgements

No conflict of interest

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