Challenges Of Adopting The Right Automated Dispensing System

Following data entry is the production or fulfillment step. This is the step where pharmacists actually fill the prescriptions. The major problem encountered in this step is not having sufficient inventory to fill a prescription. This can be frustrating for the pharmacist and the customer. A possible solution to this problem is to fill the prescription in part; enough to get the customer started on their medication, and then when new shipment arrives fill the remaining portion of the prescription. This would require an entry to the customer’s record so that employees know the prescription was only partially filled. Also in order to implement this process, we would need our suppliers to expedite shipping of our restock orders. As a market leader, CVS should have no problem in getting its suppliers to work with them.

Dispensing- To prepare and distribute medicines (i.e. the prescription is given to the pharmacist at the chemist to fill) Supporting – Administering – Checking medication requirements against the Medication Administration Record and prepare and give these to the service user: open bottles and packets of tablets and remove them for the service user to take; pour out a dosage of medicine; open a medication compliance aid and give the medication to the service user to take; apply creams; apply eye, ear, and nose drops.

The pharmacy, nursing, and informatics department were required to be involved in implementing the bar-code-assisted medication administration (BCMA) patient safety initiative. The involvement of the informatics department was required for planning and coordination of the electronic medication administration record and the scanning devices. The nurses were administering the medications so they were required to undergo training on BCMA methods and the importance of BCMA implementation. Pharmacists were needed to assist nurses in case if a scanning error occurred. Pharmacy, nursing, and informatics staff members were responsible for evaluation of the BCMA system upon implementation.

In the classroom, it is very important to have lab safety. In a hospital pharmacy, lab safety is essential to ensuring a safe dosage to each patient. Throughout my time interning as a pharmacist at the UVM Medical center, I was often observing how much pharmacists used DoseEdge software. DoseEdge automated system that assists the process of dose routing and preparation. This product of Baxter has allowed the tasks of pharmacy change. The focus of my project was “How does current and future technology affect efficiency and accuracy in pharmacy practice?”. Through my research of Baxter’s website, articles about their product, and reports of advancing technologies in pharmacy, I found that DoseEdge is very successful in productivity and safety in the workplace. Before DoseEdge, everything was required to be prepared by hand. This required a lot of responsibility for for pharmacists and technicians to make the correct dosage in the quickest manner. Medicine is very important to a hospital, so it is very important to have the most efficient way in preparing and distributing it. This allows pharmacist to have a better way of double-checking the preparation of drugs. In each IV hood, there is an overhead camera that takes pictures of what drug and how much of it the technician is using. Pharmacist can view multiple orders all by computer without the need of being physically next to the technician. There are also requirements to have two pharmacists check the same order for high risk drugs like chemotherapy. This

The nurse must verify the physician’s medication order, including the dose and time, and then the pharmacy is responsible for their own checks and balances via the BCMA system in order to complete the dispensing phase of the medication (Gooder, 2011). The nurse enters the BCMA system with a login and password and is able then to see a list of the virtual due list for a specific patient. The computer on wheels is then taken to that patient’s room and the five rights of medication administration begin. As nurses, we are taught to use the five rights of drug administration are (1) right patient (2) right medication (3) right dose (4) right route and (5) right time. By scanning the barcode on the patient’s hospital identification band, the nurse then asks for the patient to verbally state their name and date of birth, which can be verified by the nurse on the virtual due list and then choses the medication that are due for administration at that time. The medication is dispensed and the nurse is able to scan the barcode on the medication, the scanning triggers the automatic documentation of the medication given (Kelly, 2012).

Currently, more responsibilities are being given to the pharmacy technician that were traditionally performed by pharmacists, such as clarifying prescriptions and entering orders. With these additional responsibilities for the pharmacy technician, this will allow the pharmacist to spend additional time with patients. However, with these additional responsibilities enables more opportunities for error. In 2008, a study was performed at Wentworth-Douglass Hospital, a 178 bed acute care facility

Encourage the use of computer-generated or electronic medication administration records. Plan for the implementation of computerized prescriber order entry systems. Consider the use of machine-readable code (i.e., bar coding) in the medication administration process. Use computerized drug profiling in the pharmacy. Be a demanding customer of pharmacy system software; encourage vendors to incorporate and assist in implementing an adequate standardized set of checks into computerized hospital pharmacy systems (e.g., screening for duplicate drug therapies, patient allergies, potential drug interactions, drug/lab interactions, dose ranges, etc.)”. (Association,

Pharmacists have many different responsibilities to their patients, these include promoting patient’s safety through checking the patient’s medication and keeping good records every time a patient fills a new prescription or refills prescription filled (Leagle, 1994). Pharmacists should also improve

Step3: If the medication is stocked in the Pyxis machine, then nurse can take it out from the Pyxis machine once the order is verified; if not, label generate in the main pharmacy, pharmacy technician pull out the correct medication from the medication carousel

Medication reconciliation is defined as a “formal process of obtaining a complete and accurate list of each patient’s current home medications – including name, dosage, frequency, and route – comparing the physician’s admission, transfer, and discharge orders to the list.” (Meguerditchian N, Krotneva, Reidel, Huang, & Tamblyn, 2013). There have been several studies performed across the world to try to comprise a system that will successfully accomplish medication reconciliation. Some of these studies have been successful and others have failed to find a solution. There have been studies that have utilized a pharmacy technician in the emergency department to facilitate the input of patient’s medication reconciliation prior to admission. Other studies have relied on the pharmacist to obtain the information. Most studies involved the primary nurse providing care to the patient to obtain the medication reconciliation information. There have been several forms of documentation tried on trial bases. These forms of documentation range from a paper medication administration record (MAR) to an electronic medication administration record (EMAR) that utilizes today’s technology.

This integrative review sought to identify and understand the impact of information technology in on medication errors. The review of 14 papers shows that the implementation of medication management systems, which include CPOE, BCMA and automated dispensing machines has successfully reduced medication errors and adverse medication events significantly, particularly the two most susceptible stages of prescription and administration of drugs (Armada et al., 2014).

Automated medication dispensers may be the key for improved quality of care and safety for individuals who live in a community-based setting. Errors and adverse incidents related to medication use are becoming more common whether it is because of cognitive changes related to aging, substance abuse or simply just not taking medications as prescribed. A working definition of medication misuse for the purposes of this paper is the use of medications, illicit, prescribed, or over-the-counter, in a manner other than as recommended or directed (Centers for Disease Control and Prevention, 2013). It has been reported that in the United States alone, 105 people die each

The problem that the community is experiencing related to medication administration is that there is no system that can be used to check the medication before administering except the RNs and LPNs themselves. Staff members are using picture of patients in the system as a way to identify patients before administering medications. They do not have barcode reader to alert them when they are about to administer wrong medications. The community is aware of this problem and started to use the same process except that the medication is checked by three nurses instead of two after entering the information into the system.

Set-up and workflow of my pharmacy is pretty good for patient centered care. Patient does not have to wait too long for their prescriptions to be filled. Patients can call for their refills via telephone or online, which makes their life easy as they don’t have bother coming in-person for refills. Patient profile shows all medication history as well as number of refills remaining. This makes it easy for pharmacist to know whether to refill a prescription or call doctor for refill request. After confirming to fill a prescription pharmacist runs claim through insurance and print label after claim is successful. All medication is arranged alphabetically on shelves, thus it is easy and quick to retrieve. Then after technician fills medication and then pharmacist checks it. This workflow is quite smooth and quick to process. Final check is done by pharmacist, who confirms right medication for right patient as well as the NDC dispensed, amount dispensed, direction for use, and day supply. All these steps of process take place on working table in sequential order, which helps to reduce errors in filling and have effective prescription filling. Once the prescription is filled pharmacist do all paper

The data entry stage has two major problems. The first problem is drug utilization review (DUR). As showed by PSI team for the pharmacy fulfillment process, DURs arise frequently and pharmacists must waste time to intervene. CVS’s central database of customer fails to update and understand customers’ newest condition, so that the issue of DUR triggers customer’s dissatisfaction and wastes a lot of time for pharmacists. The second problem in the data entry stage is no refill allowance. Many customers may lose track of how many refills that were allowed and drop off an ineligible script