Estimated Cost Savings from Reducing Errors in the Preparation of Sterile Doses of Medications

Urbine, Terry F.; Schneider, Philip J.

doi:10.1310/hpj4908-731

Cited by 5 publications

(10 citation statements)

References 55 publications

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“…Shifting the preparation of injectable medication from nurses on the ward to the hospital pharmacy is an emerging development. It is even estimated that using robotic devices to prepare medications in the hospital pharmacy can reduce healthcare costs and medication errors (Urbine and Schneider, 2014).…”

Section: Discussionmentioning

confidence: 99%

Double checking injectable medication administration: Does the protocol fit clinical practice?

et al. 2019

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Objectives: It is unclear how nurses adjust the double check during injectable medication administration andguarantee patient safety. We used the Functional Resonance Analysis Method (FRAM) to determine the fit betweenthe double check according to the protocol (work-as-imagined) and clinical practice (work-as-done). Weaimed to learn about process variation in order to optimize safety during injectable medication administration. Methods: A qualitative study (February-July 2018) with semi-structured group interviews. An internal medicineand a surgery ward of two Dutch hospitals participated (four wards total). We interviewed nurses about injectable medication administration practices, based on prior observations. A work-as-done model was constructedfor each hospital. The work-as-imagined model was based on the Dutch protocol for safe injectablemedication administration. Results: A total of 27 nurses were interviewed. In both hospitals, nurses split the double check into a digital andphysical check to improve workflow. The digital check was routinely conducted. For the physical check, nursesmade their own risk-impact analysis and assessed staffing, familiarity with the medication, severity of sideeffects, type of 

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Section: Discussionmentioning

confidence: 99%

Double checking injectable medication administration: Does the protocol fit clinical practice?

et al. 2019

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“…One noncontrolled study [ 30 ] also showed that the robot had good production efficiency, and one in-depth interview [ 28 ] revealed that the robot improved the production efficiency by 3 to 5 times compared with the traditional manual preparation. Four studies showed that with increases in pharmacists’ familiarity with robots [ 10 , 34 ] and increases in the quantity of preparations, [ 7 , 26 , 34 ] the production efficiency of the robot groups was further improved. In one controlled study, [ 19 ] the number of preparations by the robot reached 70.4% of the total number of preparations in the inpatient ward, and similarly, another controlled study [ 37 ] showed the annual output increased by 50.4% after the introduction of the robot.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [ 7 , 8 , 10 , 22 ] conducted an economic evaluation. An economic study [ 8 ] showed that robots could reduce healthcare costs by preventing medication errors and reducing adverse drug events, saving an average of $288,350 per year.…”

Section: Resultsmentioning

confidence: 99%

“…[ 5 ] According to data released by the American College of Hospital Pharmacists, 0.3% of hospitals have introduced intravenous compounding robots. [ 6 ] In 2014, Urbine et al [ 7 ] found that the use of the robotic device prevented 5420 medication errors and resulted in an associated savings of $288,350 per year. In 2019, Amodeo et al [ 8 ] found that the application of intravenous compounding robots increases precision, improves safety, decreases costs, and saves time.…”

Section: Introductionmentioning

confidence: 99%

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Intravenous compounding robots in pharmacy intravenous admixture services: A systematic review

Yang

Zhang

et al. 2023

Medicine

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Background: There is a lack of best evidence of intravenous compounding robots for hospital decision-makers. This study aimed to conduct a systematic review of intravenous compounding robots. Methods: A comprehensive search of relevant professional health technology assessment websites and electronic databases was conducted from inception to February 3, 2022. Current studies related to intravenous compounding robots were included in this systematic review. Two reviewers independently screened the literature, extracted data, and assessed quality. The results were reported by qualitative description because of heterogeneity in the characteristics of the data in the included studies. Results: Thirty-three studies were included. Effectiveness: The robots improved production efficiency compared with usual/manual preparation; however, the intravenous preparation process requires further optimization. Additionally, robots reduced the incidence of medicine residues, preparation errors, and preparation failures. The solution properties of intravenous admixture medicines were satisfactory, and the robots also contributed to error recognition. Safety: The robots reduced product pollution and environmental pollution, but vigilance is still required to ensure that pollution stays low. The robots also reduced the incidence of health damage to technicians. Economy: The robots reduced material costs in these studies; however, whether they can reduce labor costs remains unclear. Social suitability: Technicians had a high degree of satisfaction with the robots, but few relevant studies focused on this aspect. Conclusions: Intravenous compounding robots have certain advantages in terms of effectiveness, safety, economy, and social adaptability.

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“…Each year during the period 2009-2011, there were 1.2 million hospitalizations with preventable adverse drug events (ADEs) related to injectable medications in the United States, with an estimated cost between $2.7 billion and $5.1 billion annually. 1 Urbine et al 2 found that automated IV preparations could virtually eliminate compounding errors, yield cost savings, and improve patient safety. This in turn led the Institute for Safe Medication Practices (ISMP) to highlight the importance of workflow standardization adoption and IV automation integration within an enterprise hospital setting to optimize patient safety and prevent harm associated with injectable medication use.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Workforce planning and safe workload in sterile compounding hospital pharmacy services

Chaker

Omair

Mohamed

et al. 2021

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose A prospective observational study was conducted to assess sterile compounding time and workforce requirements in a hospital pharmacy, resulting in development of staff benchmarking metrics. Methods The study was conducted in the IV room of a quaternary hospital over a total of 7 weeks. Compounding was directly observed and timing data collected for each compounded sterile preparation (CSP). The primary objective was to assess CSP workload, compounding time requirements, and workforce requirements to enable development of a data-driven staffing benchmark. Results A total of 320 sterile product preparations were directly observed during the study. Overall, the average time to compound 1 CSP (including small- and large-volume parenteral solutions, chemotherapy CSPs, batched CSPs, and syringes) was 3.25 minutes. Chemotherapy CSPs had the longest average preparation time (17.74 minutes); batched CSPs had the shortest preparation time, at 1.90 minutes per unit. A safe workload analysis indicated that in an 8-hour shift, 1 pharmacy technician can safely prepare 253 batched CSPs; 148 preparations of SVP solutions, LVP solutions, and syringes combined; 31 parenteral nutrition solutions prepared using an automated device; or 29 chemotherapy preparations. Through extrapolation of these results, it was calculated that a hospital with a capacity of 100 beds would require 1.4 pharmacist full-time equivalents (FTEs) and 2.7 technician FTEs to meet its sterile compounding needs, with proportionate increases in those estimates for a 300-bed hospital. Conclusion Organizations wishing to use external benchmarking information need to understand data characterization, pharmacy services offered, automation, workflows, and workload before utilizing that information for workforce planning.

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Estimated Cost Savings from Reducing Errors in the Preparation of Sterile Doses of Medications

Abstract: The use of a robotic device can reduce health care costs by preventing errors that can cause adverse drug events.

Cited by 5 publications

References 55 publications

Double checking injectable medication administration: Does the protocol fit clinical practice?

Double checking injectable medication administration: Does the protocol fit clinical practice?

Intravenous compounding robots in pharmacy intravenous admixture services: A systematic review

Workforce planning and safe workload in sterile compounding hospital pharmacy services

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