Hospital nurses share the responsibility with hospital pharmacists in ensuring that every step of the medication cycle-storage, preparation, distribution, and administration to patients-is managed safely and effectively. And in the age of managed care, nurses and pharmacists are under constant pressure to enhance productivity and minimize waste.
One way to achieve these goals is through advances in medication management technologies. These technologies have evolved over the past 50 years into sophisticated systems that help minimize costs and maximize patient safety and medication security.
To better track medications, the University of Tennessee Medical Center (UTMC) in Knoxville implemented patient-specific medication software on its automated dispensing cabinets. This software implementation has reduced the time that unit nurses spend on managing medications, which translates into increased staff efficiencies and improvements for both pharmacy and nursing.
The automated patient-specific medication management software also provides a single point of profile-based access for all of a patient's medications. This access virtually eliminates missing doses. Clinical and profile checks are now applied to all patient medications, including those previously stored outside the cabinets, reducing the potential for medication errors. What's the result of these increased efficiencies? More time for patient care, better compliance with the prescribed medication therapy, and increased nursing satisfaction.
The extra medical costs of treating drug-related injuries occurring in hospitals alone conservatively amounts to $3.5 billion a year, and this estimate doesn't account for lost wages and productivity or additional healthcare costs, according to a recent Institute of Medicine report.1 The evidence is everywhere as the news of medication mix-ups continues to be at the forefront.
Software enhancements
Installation of the new automated patient-specific medication software in UTMC's nephrology unit provided enhancements to the two automated dispensing cabinets already in the nursing unit. With traditional medication dispensing cabinets, multiple secure compartments are currently designed to contain a supply of one specific medication; nurses are able to routinely obtain the most commonly used medications from the cabinet. Locating medications not commonly stored in the cabinet due to infrequent use (such as eye drops, creams, and inhalers) wastes nurses' time.
After implementing the automated patient-specific medication software, UTMC nurses addressed the challenges of managing the unit's medication process by having a single point of access for medications-the automated dispensing cabinets. Patient-specific medication restock levels are now calculated automatically based on order frequency and actual usage. The system also automatically assigns each patient's medications to the automated dispensing cabinet location for the pharmacy, eliminating the manual assignment of medications to a given location. These restock efficiencies result in a consistent process for nursing.
Additional features, such as automated removal of discontinued medications, removal and tracking of medications for patients that have been discharged or transferred, and message notifications to nurses and the pharmacy, further enhance patient safety.
A favorable adoption
Despite advances, challenges remain in creating a standardized medication management system with performance that's demonstrably superior enough in every respect that hospitals will adopt it exclusively. The experience of the UTMC nephrology unit serves as a solid case study in favor of adopting a patient-specific medication management system that unites nursing and pharmacy in increasing patient safety.
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