Hospital pharmacies are increasing efficiency and patient safety with the implementation of new technology such as sterile IV preparation robots. These robots are able to prepare admixtures within a clean air-controlled environment while remaining compliant with USP 797 requirements.
Although intravenous robot designs vary, each robot comes equipped with HEPA filters, a compounding area, barcode scanners, a scale, and an attached computer system. The interior of the machine is initially sterilized by the pharmacy technician in charge of operations prior to the addition of tubing and ingredients. The scale is calibrated as needed to ensure quality control. As each ingredient is added, an image of the product is captured which include the lot numbers and expiration dates; these are stored in an easily accessed database for future reference. Powdered vials are reconstituted automatically by the machine, and weighed for accuracy before production. After the the robot is programmed to begin, specifications of the operation are checked by a pharmacist for accuracy; this is also done again upon completion.
IV robots have the ability to compound patient specific medication orders or batch thousands of IV doses per day. Many are able to fill syringes or intravenous bags. The frequency by which doses are weighed for quality control is based on type. Every patient specific dose and usually every third to fifth batched item is weighed and validated against a certain range of error. There is a defined standard deviation that the doses have to meet in order to pass quality checks. When there is a discrepancy in weight (i.e. it falls outside the acceptable standard deviation), the robot rejects the item and subsequently sends it to a rejection drawer/ bin. Every order compounded is labeled with patient specific information (when available), medication information, and a barcode for scanning.
Some IV robots have the ability to send a text message to a pager carried by the operating pharmacy technician. This allows the technician to migrate to other areas within the IV room where help is needed increasing efficiency. Other benefits that come with IV robots are high productivity, reduction in employee injury from repetitive tasks, and better patient safety.
Robot designs have evolved allowing an opportunity for IV robots to be decentralized from pharmacy. Pharmacists are able to keep overall control of the preparation process while increasing efficiency and availability of admixtures on nursing units. Overnight sterility is accomplished in these machines through the use of UV-C lamps.
Hazardous IV preparation robots are also available. They are able to support chemotherapy, monoclonal antibody therapy, and gene therapy preparations. With every compounded item produced by these machines there is a decrease in operator risk of exposure, needle-stick injuries, and repetitive strain.
Some other new additions for hospital pharmacy robots may include built-in controlled substance support such as tamper evident caps and single slot access.