Background The preparation of antiblastic chemotherapy drugs is an activity of high clinical risk because an error in the preparation phase can result in severe damage to the patient. The robotic system APOTECAchemo has been in use in our centre since 2014. The system is not only able to intercept potential errors in the stage of preparation of therapies but is also equipped with software that records any potential errors to ensure continuous monitoring inside the antiblastic medication unit.

Purpose In order to improve the production process by getting the attention of the operators that work in the antiblastic medication unit every day, we carried out an analysis of the errors that represent the potential critical points in the preparation phase.

Material and methods We analysed the medication errors intercepted by the robots in the period between November 2016 and May 2017. The software APOTECAm@a for the real-time monitoring of the performance records and reports all the stopped errors thanks to controls at different levels: expiry date control of the drugs, load of the right components through barcode reading, components weight control and drug label identification.

Results The robotic system intercepted a total of 70 errors on 3090 preparations, which could have been dispatched if the equipment had not been computerised and robotised. Six types of errors were identified: preparations with expiry date prior to the delivery date (14%); incorrect residual vials loaded (9%); wrong format and/or solvent of the loaded bag (60%); incorrect weight of a loaded component (erroneous loading of residue vials/incorrect filling of infusion pump) (11%); reading a barcode already used for another preparation (infusion pump) (3%); and the loaded drug not corresponding to the prescription (3%).

Conclusion The study showed that the incidence of medication errors associated with human distraction is significant (2.3%). The picking of a wrong bag format and the expiry date of the medication prior to infusion date are the most common mistakes. Despite intercepting and avoiding human errors, robotics allows real-time monitoring of different key performance indicators, like intercepted medication errors, which guarantees the continuous improvement of the production process.

References and/or Acknowledgements Thanks to staff pharmacy and Loccioni Humancare

No conflict of interest