RESUMO
PURPOSE: This study is an evaluation of technology-assisted technician verification (TATV) of the compounded sterile product (CSP) preparation process as an alternative to final verification by a pharmacist. METHODS: A 2-phase, single-center noninferiority study was conducted to assess the accuracy and CSP processing time with TATV versus pharmacist verification. Phase I of the study was a validation of the internal pharmacist accuracy rate in which 2 pharmacists checked each CSP. In phase II, prepared CSPs were first checked by a technician and then checked by a pharmacist. Technicians were required to complete baseline credentialing and training requirements to participate in the study. The primary outcome was the error rate for the pharmacist check in phase I and the error rate of the technician check in phase II. Secondary outcomes included total verification time and total dose processing time in each phase. The Farrington-Manning test was used for noninferiority assessment of accuracy, and the Wilcoxon rank sum test was used to detect a difference between the processing times. RESULTS: A total of 4,000 doses were checked in each phase. Pharmacist accuracy was 99.600% in phase I, compared to TATV accuracy of 99.575% in phase II. TATV of CSPs was noninferior to pharmacist verification (absolute difference in accuracy, 0.025%; 95% CI, -0.26% to 0.31%; P = 0.0016). Total verification time and total dose processing times were significantly lower in Phase II. CONCLUSION: This study showed that TATV of CSPs is noninferior to pharmacist final verification and does not negatively impact the time to check CSPs or total CSP processing time.
Assuntos
Farmacêuticos , Tecnologia , Humanos , Técnicos em FarmáciaRESUMO
PURPOSE: This study aims to show the feasibility and sustainability of technician barcode scanning verification as an alternative to pharmacist visual verification of first dose medications in an acute care setting. METHODS: A two-phase, noninferiority, single-center study was conducted to compare the accuracy of technician barcode scanning verification to pharmacist visual verification of pre-packaged first dose medications within a large acute care medical center. In phase 1, a pharmacy technician utilized barcode scanning as a means of verification. These preparations were then re-verified for accuracy by pharmacist visual verification. In phase 2, the verification order was reversed, starting with pharmacist visual verification of first doses, which were subsequently re-verified by a technician utilizing barcode scanning. Accuracy and efficiency (first dose processing time) of each phase was analyzed via error logs and retrospective dose tracking. RESULTS: A total of 12,328 first dose preparations were included in the analysis and showed no difference between technician barcode scanning verification and pharmacist visual verification. Retrospective time study showed a 4-minute decrease in processing time when doses were verified by technician barcode scanning. Based on initial study outcomes, a variance was granted to pilot first dose tech-check-tech by the Wisconsin State Board of Pharmacy. CONCLUSION: This study determined that there is no difference in verification accuracy between technician barcode scanning verification and pharmacist visual verification of first doses in an acute care setting. Through leveraging technology and skill mix, Froedtert Hospital was able to provide the same level of patient safety while decreasing pharmacy processing time, developing our technician workforce, and reallocating pharmacist staff from distributive roles in central pharmacy to decentralized clinical activities.