Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital.

Purpose Interventions to improve the safety and efficiency of manual sterile compounding are needed. This study evaluated the impact of a technology-assisted workflow system (TAWS) on sterile compounding safety (checks, traceability, and error detection), and efficiency (task time). Methods Observat...

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Published in:American Journal of Health-System Pharmacy Vol. 79; no. 19; pp. 1685 - 1697
Main Authors: Fan, Mark, Yang, Danny, Ng, Becky, Jackson, Jocelyn, Bouris, Katherine, Eng, Sharon, Rolko, Edith, Trbovich, Patricia
Format: research tables/charts Journal Article
Published: Oxford University Press / USA Oct2022
Online Access:View this record in EBSCOhost
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      jtl: American Journal of Health-System Pharmacy
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      dt: Oct2022
      vid: 79
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      pub: Oxford University Press / USA
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        atl: Impact of technology-assisted versus manual sterile compounding on safety and efficiency in a Canadian community hospital.
      aug:
        au:
          Fan, Mark
          Yang, Danny
          Ng, Becky
          Jackson, Jocelyn
          Bouris, Katherine
          Eng, Sharon
          Rolko, Edith
          Trbovich, Patricia
        affil: Centre for Research and Innovation, North York General Hospital , Toronto, ON , Canada
      sug:
        subj:
          Drug Compounding Methods
          Patient Safety Evaluation
          Workflow
          Information Technology
          Hospitals, Community Canada
          Productivity Evaluation
          Technology, Pharmaceutical
          Canada
          Human
          Pharmacy Service
          Medication Errors Classification
          Chemistry, Analytical
          Documentation
          Bar Coding
          Drug Storage Equipment and Supplies
      ab: Purpose Interventions to improve the safety and efficiency of manual sterile compounding are needed. This study evaluated the impact of a technology-assisted workflow system (TAWS) on sterile compounding safety (checks, traceability, and error detection), and efficiency (task time). Methods Observations were conducted in an oncology pharmacy transitioning from a manual to a TAWS process for sterile compounding. Process maps were generated to compare manual and TAWS checks and traceability. The numbers and types of errors detected were collected, and task times were observed directly or via TAWS data logs. Results Analysis of safety outcomes showed that, depending on preparation type, 3 to 4 product checks occurred in the manual process, compared to 6 to 10 checks with TAWS use. TAWS checks (barcoding and gravimetric verification) produced better traceability (documentation). The rate of incorrect-drug errors decreased with technology-assisted compounding (from 0.4% [5 of 1,350 preparations] with the manual process to 0% [0 of 1,565 preparations] with TAWS use; P < 0.02). The TAWS increased detection of (1) errors in the amount of drug withdrawn from vials (manual vs TAWS, 0.4% [5/1,350] vs 1.2% [18/1565]; P < 0.02), and (2) errors in the amount of drug injected into the final container (manual vs TAWS, 0% [0/1,236] vs 0.9% [11/1,272]; P < 0.002). With regard to efficiency outcomes, TAWS use increased the mean mixing time (manual vs TAWS, 275 seconds vs 355 seconds; P < 0.001), had no significant impact on average visual checking time (manual vs TAWS, 21.4 seconds vs 21.6 seconds), and decreased average physical checking time (manual vs TAWS, 58.6 seconds vs 50.9 seconds; P < 0.001). Conclusion In comparison to manual sterile compounding, use of the TAWS improved safety through more frequent and rigorous checks, improved traceability (via superior documentation), and enhanced error detection. Results related to efficiency were mixed.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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