Abstract

THE IMPACT OF IMPLEMENTING AN AUTOMATED DISPENSING SYSTEM (ADS) IN A TERTIARY HOSPITAL IN THE UNITED ARAB EMIRATES (UAE)

Mubarak Nasser Al Ameri*, Saba Mohsin Aljasmi, Saeed H. Abdulla, Emad Makramalla, Ahmad M. Dawaghreh, Amin M. El Shamy and M. Sadiq Sohail

ABSTRACT

Introduction: Technology in hospitalizations has been developed over the past two decades to automate the stages of in-patient drug distribution in hospitals. Those include ordering, dispensing, delivery and administration of medication. The implementation of Automated Dispensing System (ADS) can improve the pharmacy and hospital performance. It can improve the inventory control, safety of the medication, reduce medication errors, reduce dispensing time and also can impact budget spend in the hospital pharmacy. However, there are potential pitfalls associated with these devices if was not properly implemented and managed. Objective: To measure the impact of
implementing ADS on patient’s medication management process including errors, safety, cost saving and administration time from the healthcare professional perspective in a tertiary Hospital in the United Arab Emirates (UAE). Method: An observational retrospective cross sectional study conducted in a tertiary hospital in the UAE using a survey for three months after implementing ADS in the in-patient wards. This study was performed from healthcare professional perspective such as pharmacists and nurses. Results: 187 end users were included in this study consists of 170 nurses and 17 pharmacists. It was highlighted in this study that there are top eight reasons toward the end-user satisfaction and other eight reasons toward end-user dissatisfaction with ADS. The reasons for the end user satisfaction included the easy access to the narcotic medication without violating the Ministry of Health Policy and Procedure in terms of dispensing narcotics, the ability to protect the medications from theft and abuse and it can contribute to better medication inventory and a better management to medication expiry with a clear reduction in medication errors after implementing ADS in the hospital. Many participated end-users agreed that ADS improves the safety of managing look-alike sound-alike medications (LASA). On the other hand, there are reasons for dissatisfaction from the end-users point of view which include that the medication list in the medication administration records (MAR) was hardly matching the medication list in the ADS which consumed sometime when searching a medication before dispensing. Dissatisfactions include that the ADS delayed obtaining medication during emergency situations and there are a lot of override option to obtain medications which was not favored by the end-user. In addition, more than half of the participated nurses and pharmacists agree that ADS allows nurses and pharmacists to access all medications needed for any patient at the right time and they were rarely have to wait in line to get patients medications from the ADS. Conclusions: It was clearly revealed in this study that the end-user satisfaction rate with ADS was high because it can lead to a better management of medications in hospitals in terms of medication safety, errors, cost saving and dispensing time. However, healthcare providers should develop procedures with aspects related to the safety of high alert medication, obtaining medications during emergency situation and look-alike sound- alike and emergency medications. Moreover, it is highly recommended to match the medication list in the (MAR) medication administration records with the medications list in the ADS system to avoid medication errors and to reduce the overrides.

Keywords: Automated Dispensing System (ADs), automated inventory control, medication management process, patients’ safety.