3) Combination of individual order of medicines and floor stock system Selected are the list of basic medicines and requirements. 1) Distribution of medicines to indoor patients (patients in the rooms, operating rooms, X-rays and other specified services) 2) Distribution of medicines to patients in the open air (patients who have not been admitted and are not in bed) • Medicines are very important so that vital medicines can be kept at the bedside if it is only to be a strip for the patient on the doctor`s order. Any drug typically manufactured and marketed by pharmaceutical companies must meet the quality standards of new drug approval in terms of safety and efficacy. Once prescribed by a doctor in a hospital, the drug, more precisely the decision on its prescription, follows a complex cycle in which many intermediaries (human and technical) are involved, leading to the administration and monitoring of the drug. Regulatory guidelines and rules harmonize and standardize this pathway of drug treatment in hospitals. Any weakness in this distribution system will be the source of nosocomial diatricogenesis of drugs. This review aims to describe the different stages and stages from single-patient prescribing to medication administration and monitoring. The evaluation of this system is mentioned with regard to optimization. The computerized system is essential, as it allows the monitoring of a drug and provides decision support (through confrontation with databases) and a research tool (i.e. Pharmacoepidemiology). Various experiences in evaluating the performance of such a drug dispensing system in hospitals are presented, trying to check the quality reference: the right drug, the right patient, the right time, in the right conditions. The challenge is to optimize and secure all stages of the process. This objective requires an evaluation and quality control of the different phases, which opens the discussion between hospital policy and regulatory and technical considerations.

A pharmacy technician checks the medications as they are dispensed by the PASK. These are stored in individual patient containers in a medicine trolley, based on a refill list generated from the Meditech system. The charging list is initialled by the filling technician. The containers are then inspected by a technician certified as an inspector or, if necessary, by a pharmacist. This type of patient is not hospitalized and receives general or emergency treatment, which can be diagnostic, therapeutic or preventive. The PACMED machine is fully automatic and contains 400 drugs as well as an STS tray (special tablet system). There is a long transparent strip with individually packaged doses of drugs worth 24 hours for individual patients. Each strip begins with a label indicating the patient`s name, room number, unique identification number, and the date and time of administration of the drug. This information is followed by individual packages of each drug for that dosing period, labeled with the generic name, strength, and batch number. The drug strip ends with a footer label that contains the same information as the header label.

Each patient`s medication strip is separated by an empty label. Under the current system, a patient`s medications are prepared by the pharmacy department and dispensed in a form ready for administration for a period of 24 hours. There is less waste and everything is in the same patient container (except refrigerated). In accordance with accreditation standards, the pharmacist reviews each order with the patient profile and relevant laboratory information. The Ontario Hospital Association (OHA), in its submission to the Ontario Pharmaceutical Inquiry, recognized the UDDS as the system of choice. Virtually every new hospital built in Canada in the last 10 years has a UDDS system. Manual dose delivery systems are labour-intensive and require physical space and personnel, which can be prohibitive; An automated UDDS does not significantly increase staff and significantly reduces the possibility of human error. This is the system that consists of an addiction to the unit dose of the patient, which contains a lot of medication. Joseph Brant Memorial Hospital was the first community hospital in its Local Healthcare Integration Network (LHIN) to introduce automated distribution of oral medication doses to patients. “When I started at Joseph Brant 11 years ago, the goal as the highest standard of care has always been to implement a fully functional unit dose system,” says Nancy Giovinazzo, Pharmacy Manager. Unit dose delivery systems (UDDS) have long established themselves as the safest form of drug delivery.

A UDDS system applies to oral medications. The equivalent for intravenous drugs is a CIVA (Central Intravenous Admixture) system. Patient safety is at the heart of many healthcare discussions. Medication errors are a very important concern in the context of the role that hospitals must play in their goal of ensuring high-quality drug-related patient care at the lowest possible cost. A hospital`s Central Supply Service (CSD) provides essential professional supplies and equipment (curtains, syringes, pipes, intermediates, etc.). After intensive research and several site visits, the hospital purchased a McKesson PACMED device. Although the system cost $250,000, Giovinazzo says, “the increase in patient safety justified the investment.” She added that this saves money in the long run because it reduces drug stocks, reduces waste and more efficient use of pharmacy and nursing staff. This goal has been brought to the fore with new, more efficient technologies available for automated dose distribution per unit. Hospitals use drugs and therapeutic substances in hospital and outpatient departments. They are so diverse that patients usually do not understand them.

3) Conducts an accurate inventory of all hospital materials and equipment. The process of generating a patient`s medication with PACMED (a series of controls and double checks) is rigorous, with patient safety always being a top priority. A pharmacist receives the doctor`s instructions for a patient`s medications for that day, checks them with the patient`s MAR (Medication Administration Record), and then enters the medication orders into the Meditech computer. (Each drug is profiled to ensure that the pharmacist has a complete record of the patient`s medications to check interactions and check dosages).