A survey of operating theatre staff on the impact of automated medication dispensing systems in operating theatres in an Australian hospital.

There is a lack of published literature investigating the impact of anaesthesia-specific automated medication dispensing systems on theatre staff. This study aimed to investigate the perspectives of theatre staff from multiple disciplines on their experience using anaesthesia stations three years after implementation at our Western Australian quaternary hospital institution. A web-based survey was distributed to 440 theatre staff, which included consultant anaesthetists, anaesthetic trainees, nurses, anaesthetic technicians and pharmacists, and 118 responses were received (response rate 26.8%). Eighty-one percent of the anaesthetic medical staff responders reported that the anaesthesia stations were fit for purpose and 66.67% of the anaesthetic medical staff reported that they were user friendly. Sixty-seven percent of anaesthetic medical staff agreed that controlled medication (e.g. schedule 8 and schedule 4 recordable) transactions were more efficient with the anaesthesia stations, and 66.67% agreed that the anaesthesia stations improved accountability for these transactions. Sixty-seven percent of anaesthetic medical staff preferred to use anaesthesia stations and 21.2% of all the responders preferred a manual medication trolley (P ≤ 0.001). This survey of user experience with anaesthesia stations was found to be predominantly positive with the majority of theatre staff and anaesthetic medical staff preferring anaesthesia stations.

Compatibility of intravenous acetaminophen with morphine, fentanyl and ketamine in acute pediatric pain setting.

BACKGROUND: Intravenous acetaminophen and opioid analgesics are routinely given concurrently to children after major surgery, where intravenous access can be limited. There is limited information about the compatibility of acetaminophen with opioid analgesics and ketamine in concentrations commonly used in pediatric setting. AIMS: We aimed to determine the physical and chemical compatibility in mixtures of intravenous acetaminophen 10 mg/mL with morphine (0.025, 0.05, 0.1, 0.2, 1, and 2 mg/ml), fentanyl (0.5, 0.75, 1, 1.5, 2, and 5 mcg/ml) and ketamine (0.01, 0.1, 0.5, 1, 1.5, and 3 mg/ml). METHODS: Acetaminophen was mixed with all 18 solutions and was examined at time 0, 15, 30, and 60 min. In Phase one of the study, we used a colorimetric method to assess preliminary feasibility and acetaminophen recovery. In Phase two study, we used high-performance liquid chromatography to evaluate the recovery of all components of the mixtures. RESULTS: All solutions tested, for both acetaminophen and the three analgesics, had more than 90% of the drug recovery, up to 60 min after mixing. CONCLUSION: Our data demonstrated the stability of acetaminophen, in combination with fentanyl, morphine, and ketamine at clinical concentrations used in acute pediatric pain setting.

An evaluation of automated dispensing cabinets and inventory robots for centralised distribution of medication in an Australian hospital.

ObjectiveIn Australian hospitals, a central distribution system is often utilised to supply medication to clinical areas. This study investigated the impact of automated dispensing cabinets (ADCs) and inventory robots in medication distribution within an Australian hospital.MethodsA prospective observational study of pharmacy technician medication supply to clinical areas was conducted over a 2-week period pre- and post-implementation of ADCs and inventory robots. Information was collected on the time taken to perform all tasks required to provide a weekly medication supply service for medication other than drugs of addiction.ResultsThere was no significant reduction of total duration for medication supply, pre-implementation mean 73.08min versus post-implementation 68.59min (P=0.567). An instance of automation downtime occurred during the post-implementation period for which manual downtime procedures were implemented. Without downtime, a significant reduction in overall time taken was observed, 74.25min versus 63.18min (P=0.019). Pre-restocking medication selection errors were reduced non-significantly after implementation of inventory robots, 11 (0.43%) versus 4 (0.21%) errors (P=0.090).ConclusionsImplementation of ADCs and robots did not significantly reduce the total time to provide a weekly medication supply service when downtime occurred, although a significant reduction was observed when downtime did not occur. Pharmacy medication selection errors were non-significantly lower.What is known about the topic?Australian hospitals are increasingly implementing automated technology such as ADCs and inventory robotics in an attempt to improve efficiency and accuracy of medication supply; however, limited literature is available in an Australian setting.What does this paper add?This paper describes the impact of implementing ADCs in clinical areas (e.g. inpatient wards) and inventory robots in a main store pharmacy on the medication supply process. This paper highlights the benefit of improved efficiency and accuracy in selecting medication in pharmacy for distribution and identifies time to restock the ADCs is significantly increased.What are the implications for practitioners?Implementing ADCs and inventory robotics in Australian hospitals can provide benefits in efficiency and accuracy; however, robust downtime procedures are essential.