RESUMO
DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting 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: To determine the impact of implementing 2 technologies in succession, the Carousel system and XR2 robot, in a hospital central pharmacy. The study examined the technologies' impact on workload shifted from fully human-involved, labor-intensive filling from shelves to Carousel and/or XR2, prevention of dispensing errors, and efficiency. METHODS: Implementation occurred in 3 phases from August 2021 through October 2022. In phase I, medications were manually filled from the shelves for immediate doses and automated dispensing cabinet stock. RobotRx was used for unit-dose (UD) carts. In phase II, the Carousel system was introduced, while RobotRx was used for UD carts. In phase III, the XR2 robot was added and RobotRx was decommissioned. Epic data and time studies were utilized and analyzed with ANOVA. RESULTS: Over the 3 phases of implementation, workload shifted away from filling from the shelves, with 2,479, 1,044, and 864 orders filled from the shelves for phase I through phase III, respectively. The Carousel workload was 1,234 orders (phase II) and 348 orders (phase III). Nearly 71% of the workload was shifted to the XR2. The overall prevented error rate did not significantly change from phase I to phase II, remaining at 0.5%. In comparison, the error rate significantly decreased to 0.41% in phase III. Use of the Carousel system resulted in a significant reduction in dispensing errors compared to manual filling from the shelves. Use of the XR2 robot resulted in a dispensing error rate of 0%. The savings in time when using both Carousel and XR2 led to a decrease in full-time equivalents of 0.77 for pharmacists and 1.76 for pharmacy technicians. CONCLUSION: Carousel and/or XR2 significantly shift workload from manual filling to automated technologies, decrease dispensing errors, and improve efficiency, reducing pharmacist and technician workload. Time saved could allow staff to spend more time on patient-centric tasks.
RESUMO
The effectiveness of visible and UV light screens, compounded in polyethylene dairy resin to protect vitamins in milk from photodegradation, was investigated. Three pigments and three UV absorbers were chosen for testing on the basis of their commercial availability, FDA approval for contact with food, and advertised compatibility with polyolefins. In this study, vitamin decomposition was accelerated over what would be experienced in a commercial milk container in order to expedite the testing program and exaggerate differences in effectiveness of the various light screens. Good protection of vitamin A and riboflavin was provided by 0.3 wt % FD&C yellow #5. Protection of ascorbic acid was marginal. Two of the UV absorbers, Cyasorb 531 and Tinuvin 326, afforded protection of vitamin A, but not riboflavin or ascorbic acid. Visible and UV spectra are presented for the vitamins and light screens used in this work.