TCH-047 The Effect of a Robotic Unit Dose Drug Dispensing System on Medicines Administration Errors and the Cost of Drug Dispensing

Abstract

<h3>Background</h3> A Unit Dose Drug Dispensing System (UDDDS) by a robot (PillPick system, Swisslog) with daily pharmaceutical monitoring of medical prescriptions is being implemented in our hospital, to gradually replace the ward stock distribution system (WSDS), which allowed a low level of pharmaceutical monitoring. In 2011, UDDDS was used for 374 beds. UDDDS allows named “ready-to-use” treatments to be dispensed daily, avoiding nurse preparation of pillboxes, necessary with WSDS. <h3>Purpose</h3> To assess the impact of a robotic UDDDS on the incidence of medicines administration errors and to assess the cost of this system. <h3>Materials and Methods</h3> Medication errors were measured using a direct observation process in two phases, before and after implementation of the UDDDS, in a 23-bed adult cardiology unit with WSDS, computerised prescription order entry and computerised medicines administration record (CristalNet). The cost study took into account both the payroll cost (pharmaceutical staff, nurses) and the cost of the robot. A monthly cost per hospital bed supported was calculated for each system. <h3>Results</h3> A total of 3233 medicines administrations were observed (1471 pre-implementation and 1762 post-implementation) for 185 patients (91 pre-implementation and 94 post-implementation). After the introduction of UDDDS the percentage of medicines administration discordances with the medical prescription fell (46% to 18%). The identification of drugs by nurses improved (18% to 1%). The monthly cost was estimated at €142 per bed with WSDS and at €161 per bed with UDDDS. Considering the distribution of depreciation and maintenance costs over 950 beds, we assume that the systems costs will become comparable. <h3>Conclusions </h3> Unit Dose Drug Dispensing by a robot is comparable to WSDS in terms of cost, while being safer, thanks to automated drug picking and pharmaceutical monitoring of medical prescriptions. Barcode verification technology is advancing. No conflict of interest.