Pharmacy Guidance Document - himss

information system. As will be mentioned in section 3.4 on bar coding and labeling, not
all bar codes work with all systems, so the re-packagers provide value by ensuring that
the bar codes created and dispensed are compatible with the facility’s information
system. Some re-packagers are also able to create “robot ready” unit-dose packages.
Re-packagers can also interface to pharmacy inventory management systems.
In which stage of medication management in the acute-care setting can drug unitdose
packaging technology be most helpful?
Re-packagers are generally used as part of the dispensing phase, although they can
also be used as part of the receiving phase when bulk items can be re-packaged before
being placed in inventory Having medications re-packaged as unit doses is also helpful
in the medication administration phase to facilitate safe practices. The creation of unitdose
packages that contain medication-specific bar codes also supports safety by
facilitating bar code scanning-enabled medication administration at the bedside.
What benefits can I expect from the use of drug unit-dose packaging technology?
How strong is the evidence for such benefits?
Vendors state that these devices can process up to 60 doses per minute for oral solid
medications and 15 to 32 doses per minute of liquid medications. 23-26 Compared to the
time required for manual re-packaging, it has been claimed that oral solid packaging
labor is reduced by 65 percent. 27 By providing ADC-specific medications, it has been
estimated that the re-packagers can reduce ADC fill time by 70 percent. 28 The dollar
value of such reductions depends on the volume of re-packaging and the extent of ADC
use at the institution.
When used in combination with inventory carousels, re-packagers can facilitate
inventory control measures. By preferentially using items stocked in the carousels that
were previously packaged over those created in real-time by the re-packager,
medication waste is reduced.
There may also be financial benefits to the purchase of bulk medications re-packaged
in-house over manufacturer supplied unit-dose medications. Manufacturer supplied
products may be more expensive and/or require additional work to be recognized by an
internal bar code scanning application. In 2006, Lanwood Regional Medical Center in
Fort Pierce, FL, was able to save $15,000 by purchasing bulk products. 29 This benefit
must be weighed against the organization’s existing inventory, cost of packaging
supplies, impact on expiration dating and technician time involved in using and
maintaining the re-packager. According to a 2008 survey by the American Society of
Health-System Pharmacists® (ASHP) on dispensing practices in hospitals, only 31
percent of hospitals re-packaged medications, primarily motivated by a desire to
achieve cost savings. 30
What potential, unintended, adverse consequences are associated with the use of
drug unit-dose packaging technology? How can the risks be mitigated?
Unit-dose packaging devices must be well maintained. Without proper maintenance,
package integrity and printing quality may be compromised and render products unsafe
©2010 by the Healthcare Information and Management Systems Society (HIMSS)
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