Drug Dispensing Systems

There are a number of drug dispensing systems for the nurse to use to dispense medication after it has been ordered for the patient. A brief description of three methods is given below.
 

Computerized Dispensing System
 

Automated or computerized dispensing systems are used in many hospitals or agencies dispensing drugs. Drugs are dispensed in the pharmacy from drug orders that are sent from the individual floors or units. Each
floor or unit has a medication cart in which medications are placed for individual patients. Medication orders are filled in the hospital pharmacy and are placed in the drug dispensing cart. When orders are filled, the cart is delivered to the unit. To administer the drugs, nurses enter the patient’s name and the drug to be administered. The drug is dispensed and automatically recorded into the computerized system. After drugs are dispensed and the cart is almost empty, it goes back to the pharmacy to be refilled and for new drug orders to be placed.
 

Unit Dose System
 

The unit dose system is a method of dispensing medications in which drug orders are filled and medications dispensed to fill each patient’s medication order(s) for a 24-hour period. The pharmacist dispenses each dose (unit) in a package that is labeled with the drug name and dosage. The drug(s) are placed in drawers in a special portable medication cart with a drawer for each patient. Many drugs are packaged by their manufacturers in unit doses. That is, each package is labeled by the manufacturer and contains one tablet or capsule, a premeasured amount of a liquid drug, a prefilled syringe, or one suppository. Hospital pharmacists also may prepare unit doses. The pharmacist restocks the cart each day with the drugs needed for the next 24-hour period. The nurse takes the drug cart into each patient’s room (Figure 2-4).
 

Some hospitals are using a bar code scanner in the administration of unit dose drugs. To use this system, a bar code is placed on the patient’s hospital identification band when the patient is admitted to the hospital. The bar codes, along with bar codes on the drug unit dose packages, are used to identify the patient and to record and charge routine and PRN drugs. The scanner also keeps an ongoing inventory of controlled substances, which eliminates the need for narcotic counts at the end of each shift.
 

Floor Stock
 

Some agencies, such as nursing homes or small hospitals, use a floor stock method to dispense drugs. Some special units in hospitals, such as the emergency department, may use this method. In this situation, drugs most frequently prescribed are kept on the unit in containers in a designated medication room or at the nurses’ station. The nurse takes the medication from the appropriate container and administers the drug to the patient and records the drug in the patient’s administration record