IV admixing
• D5 Water - 1.2 mL• D50 Water - 3 mL• NaCl - 0.5 mL• KCl - 0.4 mL• Ca gluconate - 4. mL• Aminosteril - 21.6 mL
= 28 mL refill q8h or 5.5 mLper hour
UNIT DOSE SYSTEMS VS TRADITIONAL SYTEMS
1. PACKAGING
2. SYSTEMS IMPROVEMENT
3. DEGREE OF UTILIZATION OF PHARMACIST’S TRAINING
Benefits of using Single-unit package
1. Each dose is identified up to the time it is administered.
2. The drug is maintained in sanitary form.
3. Liquids and injectables are more accurately measured.
4. Injectables are reading for immediate use.
5. Drug waste is reduced.
Benefits of UDDS
1. Nursing time spent ordering, picking up, preparing and pouring medications is virtually eliminated.
2. Charting of medications is more accurate and less time consuming.
3. Medication errors are dramatically reduced.
4. Reductions in medication errors lower the risk of malpractice suits against the hospital and its staff.
Benefits of UDDS
5. Control of drug use of the nursing unit is improved.
6. Improved drug-use control fosters improved budget and inventory control.
7. Patient billing is more accurate.
8. Fewer charge documents are handled by the Pharmacy and by the business office.
9. Drug waste due to out of date floor stock is cut down.
Benefits of UDDS
10. Drug potency and stability are better maintained.
11. Overall drug cost are reduced.
12. The system is much more simpler.
Benefits of increasing pxs health care responsibility
– Provides pharmacist with and ongoing review of the pxs total drug therapy.
Benefits of increasing pxs health care responsibility
– Pharmacist may easily provide drug information to physicians and nurses.
Four major forms of unit dose system:
1. Centralized systems
2. Decentralized systems
3. Combined systems
4. Partial unit dose
Centralized Unit Dose
• Most common because it’s the most cost-efficient.
Procedure:
1. Physician’s orders are interpreted
2. Pharmacists check for any discrepancies in the medication profile.
3. Drug doses are picked and placed in the patient drawers.
4. Pharmacy records are kept in the central area.
Name of H O S P I T A LP A T I E N T D A T A B A S E
Current Drug Therapy
NAME ROOM/BEDNO.
AGE SEX
MEDICATIONSGeneric Name (Brand Name)
Dose Frequency & Time
MD
PRN MEDS IVF
Drug History Discontinued Medicines
Remarks
Advantages and Disadvantages
• Economy of scale• Easy to fill staffing
vacancies when someone is absent from work.
• Lay-out and physical characteristics of a hospital.
Eg. Pneumatic tubes
elevators
messengers
several buildings
Decentralized Unit dose
• Have one or more satellite pharmacies scattered throughout the hospital from which most of the single unit doses are distributed.
• Packaging of medications are carried out centrally in decentralized systems.
Advantages and Disadvantages
• Strong communication link among medical professionals.
• Closer contact to patients.
• Increased job satisfaction• Higher caliber, better
motivated work force with lower staff turnover.
• Cost more
Loss of some economy of scale, need for multiple renovation of pharmacy sites, need for larger drug inventory and more personnel.
Centralized + Decentralized?
• Pharmacist are decentralized.
• Pharmacist Technician are centralized.
Setting up of medication parts is done centrally (Technicians) while the carts are checked and patient profiles are maintained in satellite pharmacy.
Advantages and Disadvantages
• Division of tasks enables personnel time to focus and give best possible service.
• Communication between technicians and Pharmacist.