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Technology (including: robots for production, Incompatibilities, drug production and analytics, CRS)
Centralised preparation of intravenous drugs in the pharmacy department: what are the options?
  1. J. Visbecq,
  2. F. Bukato,
  3. I. Dagrenat,
  4. M. Boisgontier,
  5. A. Liebbe
  1. 1Centre Hospitalier De Compiegne, Pharmacy, Compiegne Cedex, France

Abstract

Background The preparation of intravenous drugs by nurses results in many drug-related errors. Centralised preparation in the pharmacy department enables INTRAVENOUS infusions to be prepared more safely.

Purpose The objective of this study was to undertake a feasibility study of different preparation scenarios for an 815-bed hospital (which uses computer-assisted prescribing):

  • Manual centralised preparation for all intravenous drugs

  • Automated centralised preparation for all intravenous drugs

  • Centralised preparation of ready-to-use syringes for selected drugs.

Materials and methods The theoretical number of preparations was estimated. The hourly spread of the preparations over a day was established. For each scenario the following criteria were studied:

Number of FTE (full time equivalents) required for pharmacists and pharmacy technicians, organisational problems, costs, feasibility depending on the drugs' stability.

Results The first two scenarios were not realistic: the benefit/ risk ratio was insufficient, organisational problems would often occur, some drugs are not stable enough and the cost was too high. In such scenarios The authors would have to make over 200 preparations per hour during the peak period. However, the third scenario: centralised preparation of ready-to-use syringes should be encouraged for particular drugs: insulin, heparin, anaesthetics. The concentration should then be standardised. Buying a pump or a syringe-filling machine depends on the number of preparations being made. The financial balance is reached, with the construction of a dedicated preparation unit, when the annual number of preparations made exceeds 22,000 ready-to-use syringes (quality control costs not included).

Conclusions Setting up a dedicated preparation unit to make ready-to-use syringes for drugs with a narrow therapeutic index would improve the quality and improve patient safety.

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