Hospital Pharmacy - October 2019 - 338

338

Hospital Pharmacy 54(5)

Table 1. Registry Movements, pre- vs post-Pyxis.
Pre-Pyxis period
Type of movement
Load/unload registry entries
Registry errors (n)
Load errors
Unload errors
Patient errors
Drug errors
Page errors
Registry corrections (n)

Morphine Morphine
10 mg
50 mg
Fentanyl
1,816
1
23
2
0
11
146

1,153
0
27
1
1
7
76

307
0
6
1
0
0
10

Post-Pyxis period
Ketamine
119
0
3
0
7
0
0

Morphine Morphine
10 mg
50 mg
Fentanyl Ketamine
1,664
0
0
0
0
0
3

1,203
0
0
0
0
0
3

342
0
0
0
0
0
3

144
0
0
0
0
0
1

Figure 1. Errors versus registry corrections, pre- vs post-Pyxis.

also required from the hospital pharmacy staff to check OR
stocks and to liaise with the surgical unit and manage drug
movement (Table 2).
Nurses and head nurses are responsible for compiling and
correcting errors in drug registries. The analysis showed they
dedicated a total of ~36 hours/month to these activities in the
pre-Pyxis period, vs ~2 hours/month in the post-Pyxis period
(Figure 2a). In addition, pharmacists performed several
inspections of the OR stock and responded to ward requests
regarding drug dispensing throughout the time period. These
activities corresponded to a total of ~9 vs ~1 hours/month
tasks in the pre- vs post-Pyxis period, respectively (Figure 2b).
Assuming an average nurse staff cost of €15/hour,23 the
~34 monthly hours saved in the OR (~270 hours over the
whole-time period) corresponded to an economic saving of
~€4,120 in OR staff time for the center over the 8-month
time horizon. Likewise, the 8 monthly hours saved from the
hospital pharmacy (64 hours over the whole-time period)
corresponded to an economic saving of ~€3,730 in pharmacy staff time (hospital pharmacy staff cost assumed
equal to €55/hour24).

In the post-Pyxis period, average OR stock quantities
were reduced for all drugs versus the pre-Pyxis period (-53%
for morphine 10 mg, -49% for morphine 50 mg, -50% for
fentanyl and ketamine), with wastage being 100% avoided
(Table 3; Figure 3).
The time required for a complete stock rotation was
derived from the data reported on paper and software records,
respectively, and was assumed to be about 14 working days
for each drug.
Over the 8-month time horizon and in the hypothesis of
complete stock turnover in 14 days, the reduction in stock
drug quantities could correspond to an economic saving of
~€22,300, while the impact of drug wastage avoidance is
modest (~€650).

Discussion
The present study was aimed at evaluating the possible
impact of an automated dispensing system, in organizational
and resource consumption terms, in the context of the surgical unit of an important center in the North of Italy. Results



Hospital Pharmacy - October 2019

Table of Contents for the Digital Edition of Hospital Pharmacy - October 2019

TOC/Verso
Disrespectful Behavior in Health System Pharmacy Practice: Consequences and Next Steps
The Orphan Drug Act: An Appropriate Approval Pathway for Treatments of Rare Diseases?
Significant Published Articles for Pharmacy Nutrition Support Practice in 2018
Impact of Delayed Oral Vancomycin for Severe Clostridium difficile Infection
Evaluation of a Hospital Pharmacist Annual Competency Program
A Retrospective Analysis of Adherence to Risk Evaluation and Mitigation Strategies Requirements for Pulmonary Arterial Hypertension Drugs
Impact of an Advanced Pharmacy Practice Experience Student-Run “Meds 2 Beds” and Discharge Counseling Program on Quality of Care
A Retrospective Surveillance of the Antibiotics Prophylactic Use of Surgical Procedures in Private Hospitals in Indonesia
Stability and Compatibility of Diphenhydramine Hydrochloride in Intravenous Admixtures: A New Look at an Old Drug
The Impact of an Automated Dispensing System for Supplying Narcotics in a Surgical Unit: The Experience of the National Cancer Institute Foundation of Milan
Hospital Pharmacy - October 2019 - Cover1
Hospital Pharmacy - October 2019 - Cover2
Hospital Pharmacy - October 2019 - 277
Hospital Pharmacy - October 2019 - TOC/Verso
Hospital Pharmacy - October 2019 - 279
Hospital Pharmacy - October 2019 - Disrespectful Behavior in Health System Pharmacy Practice: Consequences and Next Steps
Hospital Pharmacy - October 2019 - 281
Hospital Pharmacy - October 2019 - 282
Hospital Pharmacy - October 2019 - The Orphan Drug Act: An Appropriate Approval Pathway for Treatments of Rare Diseases?
Hospital Pharmacy - October 2019 - 284
Hospital Pharmacy - October 2019 - Significant Published Articles for Pharmacy Nutrition Support Practice in 2018
Hospital Pharmacy - October 2019 - 286
Hospital Pharmacy - October 2019 - 287
Hospital Pharmacy - October 2019 - 288
Hospital Pharmacy - October 2019 - 289
Hospital Pharmacy - October 2019 - 290
Hospital Pharmacy - October 2019 - 291
Hospital Pharmacy - October 2019 - 292
Hospital Pharmacy - October 2019 - 293
Hospital Pharmacy - October 2019 - Impact of Delayed Oral Vancomycin for Severe Clostridium difficile Infection
Hospital Pharmacy - October 2019 - 295
Hospital Pharmacy - October 2019 - 296
Hospital Pharmacy - October 2019 - 297
Hospital Pharmacy - October 2019 - 298
Hospital Pharmacy - October 2019 - 299
Hospital Pharmacy - October 2019 - Evaluation of a Hospital Pharmacist Annual Competency Program
Hospital Pharmacy - October 2019 - 301
Hospital Pharmacy - October 2019 - 302
Hospital Pharmacy - October 2019 - 303
Hospital Pharmacy - October 2019 - 304
Hospital Pharmacy - October 2019 - 305
Hospital Pharmacy - October 2019 - 306
Hospital Pharmacy - October 2019 - 307
Hospital Pharmacy - October 2019 - 308
Hospital Pharmacy - October 2019 - A Retrospective Analysis of Adherence to Risk Evaluation and Mitigation Strategies Requirements for Pulmonary Arterial Hypertension Drugs
Hospital Pharmacy - October 2019 - 310
Hospital Pharmacy - October 2019 - 311
Hospital Pharmacy - October 2019 - 312
Hospital Pharmacy - October 2019 - 313
Hospital Pharmacy - October 2019 - Impact of an Advanced Pharmacy Practice Experience Student-Run “Meds 2 Beds” and Discharge Counseling Program on Quality of Care
Hospital Pharmacy - October 2019 - 315
Hospital Pharmacy - October 2019 - 316
Hospital Pharmacy - October 2019 - 317
Hospital Pharmacy - October 2019 - 318
Hospital Pharmacy - October 2019 - 319
Hospital Pharmacy - October 2019 - 320
Hospital Pharmacy - October 2019 - 321
Hospital Pharmacy - October 2019 - 322
Hospital Pharmacy - October 2019 - A Retrospective Surveillance of the Antibiotics Prophylactic Use of Surgical Procedures in Private Hospitals in Indonesia
Hospital Pharmacy - October 2019 - 324
Hospital Pharmacy - October 2019 - 325
Hospital Pharmacy - October 2019 - 326
Hospital Pharmacy - October 2019 - 327
Hospital Pharmacy - October 2019 - 328
Hospital Pharmacy - October 2019 - 329
Hospital Pharmacy - October 2019 - Stability and Compatibility of Diphenhydramine Hydrochloride in Intravenous Admixtures: A New Look at an Old Drug
Hospital Pharmacy - October 2019 - 331
Hospital Pharmacy - October 2019 - 332
Hospital Pharmacy - October 2019 - 333
Hospital Pharmacy - October 2019 - 334
Hospital Pharmacy - October 2019 - The Impact of an Automated Dispensing System for Supplying Narcotics in a Surgical Unit: The Experience of the National Cancer Institute Foundation of Milan
Hospital Pharmacy - October 2019 - 336
Hospital Pharmacy - October 2019 - 337
Hospital Pharmacy - October 2019 - 338
Hospital Pharmacy - October 2019 - 339
Hospital Pharmacy - October 2019 - 340
Hospital Pharmacy - October 2019 - 341
Hospital Pharmacy - October 2019 - 342
Hospital Pharmacy - October 2019 - 343
Hospital Pharmacy - October 2019 - 344
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