Automated dispensing cabinet
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An automated dispensing cabinet (ADC) is a computerized drug storage device or cabinet designed for hospitals. ADCs allow medications to be stored and dispensed near the point of care while controlling and tracking drug distribution. They also are called unit-based cabinets (UBCs), automated dispensing devices (ADDs), automated distribution cabinets or automated dispensing machines (ADMs).
Hospital pharmacies have traditionally provided medications for patients by filling patient-specific cassettes of unit-dose medications that were then delivered to the nursing unit and stored in medication cabinets or carts. ADCs, which are designed to replace non-automated floor stock storage, were introduced in hospitals in the 1980s and have facilitated the transition to alternative delivery models and more decentralized medication distribution systems.
While no one method for medication distribution works for every facility, implementing automated dispensing cabinets as part of a decentralized or hybrid medication distribution system can improve patient safety and the accountability of the inventory, streamline certain billing processes, and ultimately, lead to increased nursing and patient satisfaction.
Because automated dispensing cabinets track user access and dispensed medications, their use can improve control over medication inventory. The real-time inventory reports generated by many cabinets can simplify the fill process and help pharmacy track expired drugs. Furthermore, by restricting individual drugs – such as high-risk medications and controlled substances – to unique drawers within the cabinet, overall inventory management, patient safety, and medication security can be improved. Automated dispensing cabinets allow the pharmacy department to profile physician orders before they are dispensed.
Automated cabinets can also enable providers to record medication charges upon dispensing, reducing the billing paperwork pharmacy is responsible for. In addition, nurses can note returned medications using the cabinets’ computers, enabling direct credits to patients’ accounts. Since automated cabinets can be located on the nursing unit floor, nursing have speedier access to a patient’s medications. Decreased wait time for medication can lead to less frustration for nursing staff and prevent conflict between the pharmacy and nursing staff. Also, shorter waiting time ensures improved patient comfort and care.
The role of automated dispensing in healthcare
Automated dispensing is a pharmacy practice in which a device dispenses medications and fills prescriptions. Automated dispensing cabinets, which can potentially handle hundreds of different medications are available from a number of manufacturers. Though members of the pharmacy community have been utilizing automation technology since the 1980s, companies are constantly refining and improving ADCs to meet changing needs and health standards in the industry.
Several goals can be met by implementing an automated solution in a healthcare facility. The most important thing a hospital pharmacy should enforce is Patient safety. Wrong drug and wrong dose errors are the most common errors associated with ADC use. Look-alike drug names and drug packages are common variables that lead to selection errors. For example, morphine and hydromorphone are two different opioid analgesics that frequently get confused.
ADCs are more than automated teller machines for drugs and reflect how design advances as well as, specific technologies, such as barcode scanning and clinical decision support, can improve medication safety. Over the years, ADCs have been adapted to facilitate compliance with emerging regulatory requirements such as pharmacy review of medication orders and safe practice recommendations.
Automated dispensing cabinets incorporate sophisticated software and electronic interfaces to synthesize high-risk steps in the medication use process. These unit-based medication repositories provide computer controlled storage, dispensation, tracking, and documentation of medication distribution on the resident care unit. Since automated dispensing cabinets are not located in the pharmacy, they are considered “decentralized” medication distribution systems. Instead, they can be found at the point of care on the resident care unit. Tracking of the stocking and distribution process can occur by interfacing the unit with a central pharmacy computer. These cabinets can also be interfaced with other external databases such as resident profiles, the facility’s admission/discharge/transfer system, and billing systems.
ADCs are designed to meet the exact needs of the nurses and pharmacists that use them. When ADCs are purchased for a facility, the order is customized for whatever the cabinet will be specifically used for.
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- Guidance on the Interdisciplinary Safe Use of Automated Dispensing Cabinets, Institute for Safe Medication Practices, 2008.
- “Special PP&P Buyer’s Guide: Automated Dispensing Cabinets”, “PP&P Magazine”, September 2006. Retrieved on 6-3-2010.
- Automated Dispensing Cabinets: Getting It Right in the Age of Automation, Medscape, 10 July 2009. Retrieved on 6-4-10.
- Automated Medication Dispensing Cabinets, Technology for Long-Term Care, 25 May 2010, Retrieved on 6-3-10.