Implementation of a robot for the preparation of intravenous drugs in a pharmacy service

L. Soumoy, C. Decoster, N. Leonard, C. Pirlot, J-D. Hecq CHU UCL Namur, site Godinne, 1, avenue Therasse , 5530 Yvoir, Belgium

Background

The reconstitution of the intravenous treatments by a Centralized IntraVenous Admixture Service (CIVAS) guarantees the chemical stability and the microbiological quality of the ready-to-use injectable drugs and contributes to the quality and the total management of the care of the patient. Consequent equipment is necessary. After laminar air flow hoods, isolators and compounding materials, the compounding robots appear in the hospital pharmacy departments

Purpose

To detail the implementation of a robot for the preparation of intravenous drugs in a CIVAS.

Material and methods

I.v. STATION™ was implemented in a restricted area of the production service. Preparations realised by peristaltic pumps was converted to the robot. Intravenous drugs were selected in accordance with several criteria: preparation frequency, long-term stability after preparation, availability of bulk,… The 3 selected preparations were: Ketamine 50mg/1ml in syringe, Morphine 1mg/ml in bag of 100ml NaCl 0,9% and Aciclovir, (100mg to 500mg) in bag of 100 ml NaCl 0,9%.

Results

Three operators were trained and deemed competent in using i.v. STATION™. Currenlty, 35% of Ketalar produced in CIVAS are produced by the robot, 47.53% of Morphine and 37% of Aciclovir.
In practice, advantages of automated preparation are a higher consistency of process and products, a higher accuracy of products, a precise and complete documentation, an integrated digitized processing.
The main disadvantages are the risk of failure. Indeed, after interventions on the machine, re-commissioning of i.v. STATION™ and the clean room is necessary. Other disadvantages are the high investment costs and high maintenance costs, a decreased worker satisfaction (early adopter), a complexity when products are switched or added and potential new errors.

Conclusions

The implementation of a robot in a CIVAS is a real daily challenge but allows us to increase quality control of preparations.

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