Implementation and evaluation of an automated dispensing system.

An institution's experience in replacing a traditional unit dose cassette-exchange system with an automated dispensing system is described. A 24-hour unit dose cassette-exchange system was replaced with an automated dispensing system (Pyxis's Medstation Rx) on a 36-bed cardiovascular surgery unit and an 8-bed cardiovascular intensive care unit. Significantly fewer missing doses were reported after Medstation Rx was implemented. No conclusions could be made about the impact of the system on the reporting of medication errors. The time savings for pharmacy associated with the filling, checking, and delivery of new medication orders equated to about 0.5 full-time equivalent (FTE). Medstation Rx also saved substantial nursing time for acquisition of controlled substances and for controlled-substance inventory taking at shift changes. A financial analysis showed that Medstation Rx could save the institution about $1 million over five years if all personnel time savings could be translated into FTE reductions. The automated system was given high marks by the nurses in a survey; 80% wanted to keep the system on their unit. Pilot implementation of an automated dispensing system improved the efficiency of drug distribution over that of the traditional unit dose cassette-exchange system.

[Pattern of experimentally-induced subcutaneous hematoma]. / Strukturierung von experimentell erzeugten Subkutanhämatomen.

Healthy persons were each injected with 1 ml autoblood into the subcutis of the inner upper arm. Following this, different objects were applied to each haematoma area and kept pressed on the area for one hour by means of a sphygmomanometer cuff (30 mm Hg), to establish whether this would lead to secondary shape or pattern changes of the haematoma. When the haematomata were compressed by shaped objects, there developed patterned blanched areas or intensity differences, respectively, becoming more marked in the course of several days in the living experimental persons. In corpses greater quantities of blood were injected (10 ml) and higher contact pressures applied (up to 180 mm Hg). In some cases a markedly delimited imprint reflecting the configuration of the object became discernible already one hour post injectionem.