Pharmacy Automation and Responsibility

Inpatient Dispensing

• Pharmaceutical services must be provided in case of automated device failure.

ASHP Guidelines

• The pharmacist in charge is responsible for specifying quality and source for drug purchases.
• The pharmacist has authority to specify drugs used for purchase.

Inpatient Dispensing Systems

• Four systems: individual prescription order, complete floor stock, combination, and unit dose.

Individual Prescription Order System

• Used by small and/or private hospitals due to reduced manpower requirements.
• Delay in obtaining medication and increased cost to patients are possible drawbacks.
• Prefilled envelopes with predetermined quantities are used on nursing units.

Complete Floor Stock System

• Drug basket method: medicine containers are replenished regularly.
• Mobile dispensing unit: a specially constructed unit with shelves, always under professional supervision.

Combination of Individual Prescription Order and Complete Floor Stock Systems

• Modified use of unit dose medications.
• Criteria for non-charge and charged floor stock include cost of preparation, frequency of use, quantity used, and hospital budget.

Unit Dose Dispensing System

• A pharmacy-coordinated method of dispensing and controlling medications.
• Defined as medications ordered, packaged, handled, administered, and charged in multiples of single dose units.
• Types: centralized unit-dose dispensing (CUDD) and decentralized unit dose dispensing (DUDD) or satellite pharmacies.

Characteristics of Unit Dose Dispensing System

• Medications are contained in single unit packages.
• Dispensed in a ready-to-administer form.
• Limited supply (not more than 24 hours) delivered to or available at patient-care areas.
• Safer for patients, more efficient and economical for institutions, and more effective method of utilizing professional resources.

Advantages of Unit Dose System

• Improved pharmaceutical services 24 hours a day.
• Patients are charged only for administered doses.
• Nurses have more time for direct patient care.
• Reduced medication errors.
• Eliminates excessive duplication of orders and paper work.
• Reduced drug inventories in patient-care areas.
• Greater adaptability to computerized and automated procedures.
• Pharmacists can perform their intended function as drug consultants.
• Decreased total cost of medication-related activities.
• Improved overall drug control and drug use monitoring.
• More accurate patient billing for drugs.
• Elimination or minimization of drug credits.
• Greater control by the pharmacist over pharmacy workload patterns and staff scheduling.

Centralized Unit-Dose Dispensing (CUDD)

• All in-patient drugs are dispensed in unit doses from a central pharmacy area.
• Medications are stored in a central area and dispensed at the time the dose is due to be given.
• Drugs are transferred from the pharmacy to the patient using medication cards.

Decentralized Unit Dose Dispensing (DUDD) - Satellite Pharmacies

• Small satellite pharmacies located on each floor of the hospital.
• Advantages: easier administration, better stability of products, and easier accounting.
• Disadvantages: high cost, time-consuming, and occupies more space for storing.

Step-by-Step Outline of Unit Dose Procedure

• Patient admission: entering patient data into the system.
• Direct copies of medication orders are sent to the pharmacist.
• Medication orders are entered into the patient profile card.
• Pharmacist checks medication orders for allergies, drug interactions, and laboratory test effects.
• Dosage schedule is coordinated with the nursing station.
• Pharmacy technician picks medication orders and places drugs in bins.
• Medication cart is filled and checked by the pharmacist.
• Nurse administers medication and makes entries on the medication record.
• Cart is rechecked upon return to pharmacy.

Other Concepts

• Patient servers: drawers in hallways for each ward, providing easy access but at a high cost.
• Pill pick systems: automated dispensing systems.
• Robotic dispensing: automated systems for dispensing medications.

This quiz covers the role of pharmacists in automating pharmaceutical services and their responsibility in specifying quality and source of medications. It also discusses the importance of backup plans in case of device failure.