Automation of dose preparation to be administered, what solutions for which objectives ?

J. Duceau Assistant pharmacist, CHR Orléans

The construction of the new Hospital of Orleans, which opened in 2015, was an opportunity to reorganize the medicine circuit. The development of Individual Nominative Dispensing (DIN) for care units, initiated manually until then, was the subject of an automation project. Different modes of DIN were considered : daily DIN for 23 units of medicines and surgery, biweekly DIN for post-acute and rehabilitation units (SSR) and weekly DIN for retirement homes and prison. The acquisition of machines for medicines dispensation was essential to implement this project and was decided by the General Management during the first reflections about the new hospital since 2005.

It was necessary to determine which types of machines are best according to the objectives of the DIN deployment in the care units.

The analysis of the different types of care units, the frequency of prescription’s modifications, the average length of stay and the consumption of medicines permitted to choose the appropriate type of machine. The final choice resulted from site visits, machines presentation by the companies, evaluation of offers, and human and organizational resources of the hospital.

Two systems were chosen : one overpackaging machine for short-stay medical and surgical services with irregular treatments, and two repackaging machines for SSR, retirement homes and prison with more stable treatments. ACCED 220® (from ECO-DEX® Company) is a machine that overpackages medicines in unit doses, has a large capacity of storage and allows returns of the non-administered doses. However it is essentially adapted for medicines presented in blisters, it requires a large floor area and it is expensive. The JV-280® Box and JV-208® Door (from JVM® Company) are machines that repackage doses, are adapted for different medicines presentations, allow fractionated doses, need a shorter floor area and are less expensive. Nevertheless their storage capacities are more limited, medicines have to be unpackaged and their expiration dates have to be revaluated.

Using two systems seemed to us the best choice to meet the needs and the characteristics of the different care units with an acceptable financial investment.

I have no conflict of interest to declare about this subject.

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