Laurence Goldberg, an independent pharmaceutical consultant, posted an article on the hub by Patient Safety Learning about unit-dose medicines distribution, increasing attention on this topic in the UK. Read the original article. In unit-dose dispensing, medication is dispensed in single doses in packages that are ready to administer to the patient. It can be used for medicines administered by any route, but oral, parenteral, and respiratory routes are especially common.
The system provides a fully closed-loop process where the patient, the drug and the healthcare professional are identified by machine readable codes and the drug administration process is linked directly to the electronic prescription and is fully recorded. There are many variations of unit-dose dispensing.
As just one example, when doctors write orders for inpatients, these orders are sent to the central pharmacy. Pharmacists verify these orders and technicians place drugs in unit-dose carts. Sections of each cart containing all medication drawers for an entire nursing unit often slide out and can be inserted into wheeled medication carts used by nurses during their medication administration cycles.
Alternatively, electronic medicine storage cabinets can be located on wards and these are attached to medicine carts which are then filled from the cabinets. Studies often compare unit-dose dispensing to a ward stock system. In a ward stock system, bulk supplies are issued from the pharmacy; the drugs are stored in a medication room on the ward. The correct number of doses must be taken out of the correct medication container for each cycle and taken to the patient for administration.
Liquids must be poured by the nurse from the appropriate bottle and each dose carefully measured. Though the practice of unit-dose dispensing is generally well accepted and has been widely implemented, the evidence for its effectiveness is modest. Most of the published studies reported reductions in medication errors of omission and commission with unit-dose dispensing compared with alternative dispensing systems such as ward stock systems.
