Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.

Join

Subscribe or Register

Existing user? Login

Medicines supply

Unit-dose drug system frees up nurses and ‘removes potential for error’

Senior hospital nurses praise unit-dose drug system, saying it streamlines their work and makes medicines administration safer.

In the image, the Calypso unit which takes individual blisters of medicine and repackages them into the individual bar coded envelopes. This new system has streamlined the work of nurses at the renal ward of the University Hospital of Leicester

Source: University Hospitals of Leicester NHS Trust / IBSL(UK)

Wanda Toscano, a UHL unit-dose laboratory pharmacist (left), and Andrea Chiarenza, a robotics technician, operate a robot that takes blisters of medicines and repackages them into individual barcoded envelopes

The introduction of a unit-dose medicines packing, distribution and administration system at University Hospital of Leicester (UHL) has streamlined the work of nurses on the renal wards, according to senior nurses at the hospital.

“Drug rounds are now more efficient and less frustrating,” said Mary Guinan, UHL’s senior nurse in renal medicine, at Robotics 2015, a conference held in Birmingham on 26 November 2015.

The UHL system, developed in collaboration with Ingegneria Biomedica Santa Lucia whose original system has already been used across 15,000 beds at 20 hospital sites in Italy, comprises a number of interlinked robots together with prescribing and logistics software. The first robot cuts sheets of blister-packed medicines into individual doses without opening the blisters. A second robot packs the doses into sachets, each labelled with a barcode, product description, batch number and expiry date. These unit-dose sachets are stored in a ward-based robot that automatically loads individual patient drawers in the medicines trolley in preparation for a medicines round and can be used to issue individual ‘as required’ or urgent doses.

It is estimated that approximately 85% of medicines stocked by a hospital pharmacy could be repackaged as unit doses, according to Gill Hartley, principal pharmacist in renal services and critical care at UHL.

To administer a medicine, the nurse scans the patient’s barcoded wristband to bring up their electronic prescription and to open their drawer. The medicine is then scanned to confirm a match with the prescription. This closed-loop process has “removed the potential for error”, making medicines administration much safer, Guinan said.

The electronic prescribing software produces “a recognisable drug chart” that is intuitive and easy to follow, explained Jackie Elton, medicines management nursing lead at UHL. The previous paper-based system often called for the use of two or three charts and it was not uncommon for mix-ups and under-dosing or double-dosing to occur, she added.

In the image, the Attis machine which robotically cuts blister strips into individual blisters ready for repackaging

Source: University Hospitals of Leicester NHS Trust / IBSL(UK)

Andrea Chiarenza, a UHL robotics technician, operates the blister cutting robot

One important advantage of the system comes from “not having to look for lost drug charts”, said Elton, who estimates that nurses spend around ten minutes searching for drug charts during every drug round. Extrapolated to the whole of the NHS, this equates to an annual sum of more than £400,000 worth of nursing time being spent looking for lost charts, she said.

More than 2,000 medicines rounds have been completed since the project was started, with the scheme contributing to the hospital’s objective of “freeing nursing time to nurse”, said Ms Elton.

The system also means that medication storage is more efficient and reliable. Daily restocking of the ward-based robot by pharmacy staff means that ward staff no longer spend time looking for medicines or going to the pharmacy to collect supplies, nor do they need to hoard supplies of medicines in unofficial locked cupboards, said Guinan.

Hartley said the discharge procedure is also more efficient under the new system, because patients are given unit-dose drugs and their own medicines are not used during their hospital stay. This means the pharmacy is less likely to need to supply fresh 28-day packs when patients are discharged. Frequent rewriting of medicines charts is also no longer necessary and, as a result, discharge letters and prescriptions are prepared in advance and there is more time for patient counselling.

The system has been in operation on four wards in the renal unit at UHL since April 2015. Preliminary results show that medicines’ expenditure on the wards has been reduced by 12–29%. The number of items dispensed each day has decreased by 45–60% and the number of duplicate items dispensed has decreased by 37–45%. Duplicate dispensing occurs when items apparently ‘go missing’ after having been dispensed and supplied to a ward. It is often quicker to re-dispense than to search for the items, explained Hartley.

The project is run by UHL in collaboration with Ingegneria Biomedica Santa Lucia, Loughborough University and the East Midlands Academic Health Sciences Network, which is funding a full economic evaluation.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20200238

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • BNF and BNF for Children

    BNF and BNF for Children

    Now available as a 1 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £138.50Buy now
  • BNF and BNF for Children

    BNF and BNF for Children

    Now available as a 2 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £262.50Buy now
  • International Research in Healthcare

    International Research in Healthcare

    Guidance for students or researchers undertaking a multi-centre research project in health services, medicines use and professional practice.

    £38.00Buy now
  • Pharmaceutical Toxicology

    Pharmaceutical Toxicology

    Explains the methodology and requirements of pre-clinical safety assessments of new medicines. Includes registration requirements and pharmacovigilance.

    £40.00Buy now
  • Good Pharmacovigilance Practice Guide

    Good Pharmacovigilance Practice Guide

    An essential guide on pharmacovigilance of medicinal products for human use. Practical advice for developing effective pharmacovigilance systems.

    £38.00Buy now

Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Supplementary images

  • In the image, a pharmacy-based robot that takes blisters of medicines and repackages them into individual bar coded envelopes. This new system has streamlined the work of nurses at the renal ward of the University Hospital of Leicester
  • In the image, a machine that robotically cuts blister strips into individual blisters ready for repackaging

Jobs you might like

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.