A three-year study of a first-generation chemotherapy-compounding robot.

PURPOSE: Results of a performance evaluation of an automated system for compounding antineoplastic preparations are reported. METHODS: Three years after the pharmacy department of a hospital in Saudi Arabia installed an i.v.-compounding robot (CytoCare, Health Robotics), data captured by the pharmacy information system and the machine's integrated software were analyzed to assess the performance of the robot in terms of compounding accuracy, days of operation, and downtime. RESULTS: The robot was used to prepare 3.82%, 10.80%, and 13.79% of selected antineoplastics compounded in 2010, 2011, and 2012, respectively. The robot failed to meet the specified dose accuracy range of ±5% in compounding 3 of 337 chemotherapy preparations (0.9%) in 2010, 349 of 1516 preparations (23%) in 2011, and 460 of 2993 preparations (15%) in 2012. The robot was operational on 40%, 39%, and 61% of available workdays in 2010, 2011, and 2012, respectively. Robot throughput relative to the pharmacy's manual compounding process was low, with substantial medication waste resulting from dose preparation failures. Implementation challenges included workflow disruptions due to robot downtime, mechanical issues (e.g., robot arm-clamping failures), difficulty obtaining gravimetric data for some drugs, and the need to recalibrate the device to accept i.v. bags, syringes, and medication vials incompatible with manufacturer specifications. CONCLUSION: The introduction of a chemotherapy-compounding robot for preparation of patient-specific i.v. antineoplastic drugs had a limited efficiency impact in practice. This solution, with its numerous limitations and technical difficulties, is not yet mature enough for universal adoption.

Identifying computerized provider order entry (CPOE) medication errors.

Computerized provider order entry (CPOE) can help reduce the occurrence of medication errors. In Saudi Arabia, CPOE has been implemented for years, with a small number of studies evaluating the impacts of CPOE on medication errors. This study was conducted through the review of reported medication and prescribing errors at one of tertiary hospital, in Riyadh, Saudi Arabia, in 2012. Data was reviewed and evaluated to identify and analyze all drug prescribing errors and subsequently exploring factors that have contributed to the identification of the drug prescribing errors by the dispensing pharmacists. Recommendations on developing policies and procedures, working in a safe environment, healthcare provider awareness, and improved technology to reduce medication errors in Saudi Arabia are discussed.

A case study on the impacts of computerized provider order entry (CPOE) system on hospital clinical workflow.

Computerized provider order entry (CPOE) is a health informatics system that helps health care providers create and manage orders for medications and other health care services. Through the automation of the ordering process, CPOE has improved the overall efficiency of hospital processes and workflow. In Saudi Arabia, CPOE has been used for years, with only a few studies evaluating the impacts of CPOE on clinical workflow. In this paper, we discuss the experience of a local hospital with the use of CPOE and its impacts on clinical workflow. Results show that there are many issues related to the implementation and use of CPOE within Saudi Arabia that must be addressed, including design, training, medication errors, alert fatigue, and system dep Recommendations for improving CPOE use within Saudi Arabia are also discussed.