Background Many publications have demonstrated that robotic automation represents a unique solution to assure absolute quality and safety of the oncologic treatment admixture process. Nevertheless, there are a small number of preparations (i.e. investigational drugs) that are currently not candidates for robotic preparation. In order to extend the total quality concept to the entire production process, we have designed and implemented an automation platform composed of: (1) a robotic system for automated admixtures (APOTECAchemo); (2) a guided preparation system to support manual admixtures (APOTECAps); (3) workflow management software that manages all pharmacy production activities for both systems (APOTECAmanager).
Purpose Here we focus the attention on APOTECAps to analyse the measurable improvements in production quality it has introduced. It is important to understand the overall impact on a pharmacy activity in relation to both error reduction and workload.
Material and methods A 4-month period of using APOTECAps was monitored in the University Hospital of Ancona (the first hospital with the entire platform). Regarding APOTECAps, the production time and errors intercepted were extrapolated from the system log file that records every single operation. Concerning the manual procedure, a third operator clocked the compounding time.
Results The number of medicines analysed was192 with 25 active ingredients. 11 mistakes were intercepted (5.7%): 3 were associated with wrong component supplied, 4 with tolerance exceeding 10%, 3 with adjustment of amount of drug or solvent.
In terms of preparation time, the mean time was 220 s and 125 s respectively for the guided and the manual preparations. The guided procedure came out 1.8 times slower than the traditional manual procedure.
Conclusion The implementation of a guided preparation system increases medicines quality and patient safety. 11 potential medicines errors were intercepted at an early stage, giving us the chance to rectify them. However, a high level of control comes with an important impact on the working time required to produce the products.
References and/or acknowledgements No conflict of interest.
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