Evaluation of an Automated Drug Distribution System in an Australian Teaching Hospital

Abstract

Aim: To assess an automated drug distribution system implemented on four wards of a large teaching hospital. Method: Pyxis Medstation System 2000 Rx was configured and installed in four inpatient care areas at Royal Adelaide Hospital. These consisted of a medical ward, a surgical ward and two intensive care areas. The system was assessed over the seven weeks immediately following implementation and was compared to the previous systems of individual patient dispensing and imprest drug supplies. The process was assessed in terms of drug inventory, drug distribution, pharmacy staff requirements, missed doses, clinical interventions and nurse satisfaction. Results: The number of pharmaceutical line items available in patient care areas was increased by 324% using the controlled storage and delivery of the automated system. Over 95% of required items were available at ward level during the trial. Pharmacists' time was reduced by 46% and technicians' time was increased by 36%. The overall staff costs increased by 2.5%. Missed doses declined from 29% to 24%. The prescription turnaround time for items in Medstations was decreased by 88% compared to pharmacy-based dispensing. Dispensing interventions by pharmacists increased by 16%. Most nurses (91 % ) in the wards preferred the automated system and 54% of nurses in the intensive care areas thought the system should be adopted. Conclusion: Automated drug distribution was successfully implemented and demonstrated increased efficiency of drug supply and improved accountability. If implemented more widely, the system could allow pharmacists to focus on improving pharmaceutical care through increased clinical activities.

Reducing medication errors in hospital discharge summaries: a randomised controlled trial

“…The review of the international literature, however, revealed that there is no clear evidence that current automated dispensing devices reduce medication errors or improve patient outcomes (Shojania et al 2001). Likewise, in Australia, there is no clear evidence to support their use for reducing medication incidents (Coombes et al 1999;Martin et al 2000).…”

“…A study to evaluate an automated drug distribution device, the Pyxis Medstation 2000 Rx, was undertaken on four wards of a teaching hospital in Adelaide (Martin et al 2000). The only types of medication error that were investigated in this study were missed doses.…”

Pharmacy Clinical and Distribution Service Delivery Models in Australian Public Hospitals

“…This was achieved with slightly less pharmacist time and increased use of technician time. 11 Several UK teaching hospitals are now using large central robotics to assist with original pack dispensing. Interestingly, the drivers in these cases were not patient safety, but the shortage of pharmacists and the need to maintain service delivery.…”

Medication safety in acute care in Australia: where are we now? Part 2: a review of strategies and activities for improving medication safety 2002-2008

“…The 2002 medication safety review [ 2 ] noted that evidence for automated drug distribution systems in reducing medication incidents was limited. Two studies that evaluated automated drug distribution in the Australian health care setting [ 32 , 33 ] did not provide clear evidence of the efficacy of automated systems for reducing error. No further Australian studies since 2002 were located.…”