Article Text
Abstract
Background The increasing attention to patient safety and the rejected medication organisation by the healthcare inspection in 2008 has led to implementation of an automated medication organisation. Medication distribution is based on a computerised physician order entry (CPOE) and individual medication is distributed daily by the pharmacy. The centralised pharmacy is organised using ARX-ROWA to store medication and Sinteco to produce individual medication rings. The medication for a therapy change or a new patient is provided by a computerised medication cabinet (VANAS).
Purpose This investigation aimed to compare the organisation of medication distribution before (2009) and after implementation (2015) of an automated medication distribution system.
Material and methods Medication organisation audits were performed in 2009 and 2015. The legal requirements of the prescription, administration schedule, agreement between prescription and administration schedule, patient medication on the nurse ward (the correct identification of the medication name, dose, expiry date and patient name), medication administration and distribution were investigated. The obtained data were processed in Excel.
Results The prescriptions that fulfilled the legal requirements increased: 4/87 (4.6%) in 2009, 195/236 (83%) in 2015. The correct administration schedules increased: 45/87 (52%) in 2009, 220/236 (93%) in 2015. Implementation of the CPOE resulted in complete agreement between the prescription and administration schedule. The correct medication identification on the nurse ward increased: 21/87 (24%) in 2009, 65/87 (79%) in 2015. No expired medicines were detected. The administration registration increased: 74/87 (85%) in 2009, 224/236 (95%) in 2015. In 2015 the administration time was verified. In 2015, 285/338 (84%) of the medication was distributed patient specific, 22/338 (7%) provided by the computerised medication cabinet and 31/338 (9%) provided by the nurse ward.
Conclusion Implementation of the automated medication distribution resulted in complete agreement between the prescription and the administration schedule and an increased presence of correct medication on the nurse ward. The automated medication organisation contributed to improved patient safety. In future, bedside scanning should be implemented to close the medication circle, and efforts have to be made to increase the results obtained.
No conflict of interest