US Pharm.
32(11):73.
Telepharmacy, which enables
pharmacists to provide pharmaceutical services from a remote location, now
helps improve safety in the chemotherapy preparation room. ScriptPro's
Telepharmacy system was recently implemented at the University of Kansas
Hospital, the first chemotherapy preparation room supported by this technology.
In hospital pharmacies,
chemotherapy preparation is a high-risk process. Critical components of this
practice include selecting the correct drug, using the exact medication
volume, and injecting the medication into the IV bag for the correct patient.
Pharmacist supervision is vital for the safe preparation of chemotherapy
medications. However, limited pharmacist resources and complications of clean
room operations hinder the step-by-step verification procedure of the
chemotherapy preparation process.
"We really wanted to make the
most efficient use of the pharmacists that we do have," said Brian O'Neal, MS,
PharmD, and Assistant Pharmacy Director at University of Kansas Hospital.
Chemotherapy preparations were
usually verified using the "syringe pullback method" at the University of
Kansas Hospital. A technician fills the syringe with medication and injects it
into the IV bag. The pharmacist then verifies how much drug was injected after
the technician pulls back the empty syringe.
"There had to be a lot of
trust between the pharmacist and technician that the syringe was pulled back
accurately," O'Neal said. "There just shouldn't be assumptions in chemotherapy
preparation."
The hospital was in need of a
system to optimize the use of clinical pharmacists by enabling verification of
prescription dispensing from an outside location. Since O'Neal was familiar
with ScriptPro's Telepharmacy, he contacted the company to see if the
technology would enable pharmacists to verify remote preparation of
chemotherapy medications. The goal of the program was to improve safety by
increasing the presence of the pharmacist at critical risk points of
chemotherapy preparation. O'Neal noted, have had a relationship with
[ScriptPro] for a number of years … We have their automation in our retail
pharmacy, and we had the idea in the inpatient pharmacy that we could use some
of their outpatient automation on the inpatient side. So we approached them
with the idea."
Using the Telepharmacy system,
a technician scans the bar code on the drug vial to ensure that the correct
medication has been selected. The technician captures electronic images of the
vial label and the filled syringe in the preparation room before injecting the
drug into the IV bag. Prior to completing the preparation process, the
technician presses a button on the Telepharmacy screen to receive verification
by a pharmacist. From outside the preparation room, a pharmacist reviews the
images of the vial, the pullback on the syringe, the IV bag, and the patient's
medication order. The images and confirmation of these steps are documented
and available for future reference.
According to O'Neal, the
preparation process at the hospital is safer with Telepharmacy. "We have
caught things since we went with this system … Now you can see exactly what
was drawn up and what was injected into the bag." The risk of potential
medication errors is significantly reduced, since positive matching to the
patient's medication order prevents using the wrong drug. In addition, small
vial labels can be enlarged on the screen for easy visibility, pharmacists are
not exposed to powerful drugs when verifying chemotherapy preparation, and the
time-consuming process of scrubbing up to enter and exit the isolated area is
eliminated.
O'Neal noted, "We wanted to
minimize assumptions when verifying chemotherapy medications. We selected
Telepharmacy, and our program is providing the assurances we want."
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