ntcucom duke univcusiti) mc6icM ccntcR VOLUME 19. NUMBER 3 JANUARY 21, 1972 DURHAM, NORTH CAROLINA* Pilot Project on Two Wards Pharmacy Institutes 'Unit Dose’ System In a move to upgrade drug distribution in the Hospital, the Duke Pharmacy Department has instituted a "unit dose" pilot project on Cushing and Halsted, two general surgery wards. Unit dose dispensing is defined as a system whereby medication doses are prepared, packaged, labeled, and dispensed in a quantity sufficient for each patient for a certain period of time. On the wards now served by the unit dose system, drugs are unit dose dispensed by pharmacists in a satellite pharmacy on Cushing. The pharmacists work directly from physicians' written drug orders and handle everything involved in drug preparation until the oral dosages, injections, and other medications are given to the nurse for administration. Twice a day, a medication cabinet containing small medication drawers, one for each patient, is delivered to the nurse on each ward nursing team. In each drawer are the individual drug doses needed by that patient from the time the cart is delivered until it is replaced by another full cart later in the day or the following day. The nurse then administers the medications at the proper times, by checking the patient's drug record prepared for her by the pharmacy. One of the biggest advantages of the unit dose system, according to Pharmacy Director Milton Skolaut, is increased safety for patients. "With the old system, drug orders were handled by several different people before they got to the patient," he explained. "With so many people involved, there was a constant chance of mistakes. With unit dose, the pharmacists, who are the experts when it comes to drugs, take care of everything until the nurse is ready to administer the drugs, thus cutting down the risk of medication errors." Another benefit, Mr. Skolaut noted, is that the nurse, who formerly had to spend much of her time helping other personnel interpret drug orders, obtaining the proper drugs, and preparing them for administration, will now be free for the nursing duties she is trained to perform. By dispensing the majority of drugs from the satellite, the pharmacy hopes to save money by putting an end to the waste caused when little-used drugs stay' -in ward medication rooms too long and have to be discarded due to deterioration. Also along economy lines, the unit dose method will permit the pharmacy to group all charges for drugs given to a ANOTHER CHECK—Pharmacy Intern Katherine McCullough checks a drug against a patient's file to make sure the patient will receive the right medication. After final checks, the drugs are placed in separate compartments for each patient in a special unit dose medication cart, (photo by Lewis Parrish) patient and provide one total bill for the Business Office. Previously, a separate charge voucher was sent to the business office for each drug prescribed for the patient. "We should be able to cut the bookkeeping work necessary for drug charges down to a small fraction of what it has been," Mr. Skolaut said. He added that unit dose drug dispensing would permit closer control of drugs. With so many drugs stocked in open ward medication rooms, pilferage was a problem. Now all except emergency (continued on page two)

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