Evaluation of Quality Improvement in Inpatient's Medication System through the Implementation of Unit Dose Drug Distribution System

Lee, In Hyang; Lee, Soonsil; Lee, Byung Koo; Choi, Won Ja; Hong, Sung Sun

Journal of Korean Society Quality Assurance Health Care 2001;8(1): 22.
Published online June 30, 2001.

Unit Dose Drug Distribution System의 도입을 통한 투약시스템의 질 향상 평가

이인향¹, 이순실¹, 이병구¹, 최원자², 홍성선³

¹서울대학교병원 약제부
²서울대학교병원 간호부
³숙명여자대학교 약학대학

Evaluation of Quality Improvement in Inpatient's Medication System through the Implementation of Unit Dose Drug Distribution System

In Hyang Lee¹, Soonsil Lee¹, Byung Koo Lee¹, Won Ja Choi², Sung Sun Hong³

¹Pharmacy Department of Seoul National University Hospital
²Nursing Department of Seoul National University Hospital
³College of Pharmacy Sookmyung University

Abstract

Background
A study comparing unit dose drug distribution system(UDS) versus traditional drug distribution system(TDS) was conducted in Seoul National University Hospital. The objectives of this study were to identify safer drug distribution system and to measure the efficiency of both systems in utilizing nursing and pharmacist's time.
Methods
The study was designed to compare the data on medication errors, nursing time and pharmacists' time before and after implementation of the UDS in the internal medicine and otorhinolaryngology care units. The data on actual medications administered to patients were obtained by a disguised observer during the study period. The data collected were then compared with the physicians' orders to determine the rate of medication errors. In addition, using ten-minute interval work-sampling method nursing and pharmacists' time were measured.
Results
About 6% of medications were administered incorrectly in the TDS, in comparison to 1.6% in the UDS. The rate of medication error decreased significantly in the UDS compared with the TDS. Mean times spent on medication-related activities by nurses were 34.1% in the TDS and 28.5% in the UDS. In the internal medicine care unit, nursing time associated with medications decreased significantly after the implementation of the UDS, but the reduction in medication-related nursing time in the otorhinolaryngology care unit was not significant. Pharmacist's medication-related work activities, increased from 2% in the TDS to 20% in the UDS. Pharmacist's time spent on therapy-related activities increased significantly.
Conclusion
The rate of medication errors in the UDS decreased significantly compared with the TDS. Time spent on medication-related activities decreased for nurses while it increased for pharmacists. In summary, the UDS was estimated to be safer and to utilize of pharmacists' and nursing time more efficiently than the TDS.

Key words Unit dose drug distribution system;Medication error;Time study;nurses;Pharmacists;