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)