DD-028 Hospital unit dose: Does this system really increase patient safety?

• Published in: European journal of hospital pharmacy. Science and practice Vol. 23; no. Suppl 1; pp. A116 - A117
• Main Authors: García-Vela, B Balañá, Galcera, C Varon, Cerrato, S Grau, Quirante, O Ferrández, Paricio, R García, Delgado, A Retamero, Martínez, N Carballo, Esnal, D Echeverría, Cuscó, M De Antonio, Sánchez, E Salas
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group LTD 01.03.2016
• Subjects: Drug dosages; Drug stores; Patient safety; Pharmacy; Technology adoption
• ISSN: 2047-9956; 2047-9964
• DOI: 10.1136/ejhpharm-2016-000875.263

BackgroundThe unit dose drug distribution system (UDDS) has been associated with an increase in patient safety and is considered an essential part of drug distribution. However, adoption of new technologies that allow real time changes in patient treatment may influence the safety associated when this system is performed once a day.PurposeTo evaluate the hospital UDDS.Material and methodsA 1 week study performed in 5 wards of a tertiary university 431 bed hospital in 2015. Two surgical and three medical wards were included. The UDDS was performed every day from 13:00 to 15:00. Data collected: unit doses and active principles dispensed for 24 h; unit doses and active principles returned to the pharmacy from the 24 h cycle; admitted and discharged patients with medication not included in the UDDS; and changes in patient treatment out of the UDDS.ResultsAbstact DD-028 Table 1Ward A B C D E Returned unit doses/dispensed unit doses*100 per dayMean (SD)15.7 (5.2)19.0 (6.7)21.4 (8.3)25.9 (9.2)21.4 (2.4)Range10.4–22.48.4–29.512.7–40.117.3–26.318.5–24.2Returned active principles/dispensed active principles*100 per dayMean (SD)26.7 (6.4)33.0 (8.2)35.9 (5.1)34.8 (9.9)25.9 (1.0)Range18.9–34.519.1–40.931.5–47.824.8–51.824.3–27.1Prescription changes/dispensed unit doses*100 per dayMean (SD)10.7 (7.9)15.4 (6.7)10.9 (7.8)11.3 (6.4)9.2 (6.1)Range1.2–31.12.2–25.51.1–23.04.4–24.72.9–23.4Admitted patients/total beds of hospitalisation in the ward*100 per dayMean (SD)14.0 (13.6)19.4 (12.6)9.3 (2.4)16.2 (6.3)12.1 (4.6)Range–31.0–35.75.7–12.56.5–22.24–18.2Discharged patients/total beds of hospitalisation in the ward*100 per dayMean (SD)14.6 (11.5)17.8 (14.0)14.5 (4.9)17.5 (1.5)12.8 (4.9)Range–31.33.3–308.6–22.215.6–19.44–18.2ConclusionAbout one-fifth of the distributed unit doses were returned to the pharmacy daily. These returned units corresponded to more than 25% of the dispensed active principles.Admitted and discharged patients, and prescription changes out of the UDDS, were the main factors that contributed to this high variability in hospitalised patient medication.Newer strategies are needed to optimise the UDDS in order to ensure the safety of this medication distribution process.References and/or AcknowledgementsAmerican Society of Hospital Pharmacists. ASHP statement on unit dose drug distribution. Am J Hosp Pharm 1989;46:2346No conflict of interest.