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April 22, 2021

Ensuring Medication Safety Through Automation Designed to Support ISMP Best Practices

Len Hom
Director, Product Marketing, Omnicell

According to the Food and Drug Administration, almost 1.5 million people in the U.S. are injured annually due to medication errors.  As these errors continue to be a major challenge and cost concern for health system pharmacy, careful monitoring and intervention is needed to help oversee medication management, including administration workflows and inventory management.

The Institute for Safe Medication Practices has established best practice guidelines for specific medication safety issues that continue to cause fatal and harmful errors in patients. Omnicell continues to collaborate with ISMP to improve pharmacy-nursing efficiency, reduce medication errors during dispensing, and support accurate medication tracking and documentation of inventory and deter drug diversion. The goal is to support the safety of the medication distribution process while making required drugs readily accessible in a variety of patient care areas.

Omnicell ® XT Automated Dispensing Systems support these ISMP standards in a number of key areas.

Secure storage options for high alert medications such as neuromuscular blockers. Automated dispensing cabinets (ADCs) configured with locked-lidded bins allow Pharmacy to segregate high-alert drugs, limiting the potential for inadvertently selecting the wrong medication or dose. Dispensing alerts promptly display a medication warning that the clinician must acknowledge before removing a medication, supporting safe removal of high-risk drugs. These alerts can also notify Pharmacy when critical medication stocks fall below par level.

Barcode scanning is leveraged throughout the medication use process – from the time the medication is distributed from the pharmacy, upon ADC stocking, and at the patient bedside prior to administration. Omnicell XT cabinets support automated printing of a label with a machine-readable barcode to help nurses verify the right medication is being administered to the right patient.  SafetyStock ® functionality, designed to support both patient safety and workflow efficiency, enforces the use of a barcode scan to ensure accurate placement of medications during restock of the cabinet and/or to confirm the correct medication is retrieved by nurses for administration to the patient.

In certain emergency situations, high risk drugs need to be quickly accessible by nurses through an “override” option. ISMP defines “override” as a process of bypassing the pharmacist’s review of a medication order to obtain a medication from the cabinet when assessment of the patient indicates that a delay in therapy would cause patient harm. Following ISMP’s recommendations for appropriate use of ADC overrides, Pharmacy can configure Omnicell cabinets so that these critical medications are immediately available in emergent cases.

Based on a series of adverse incidents, ISMP now recommends entering the first five letters of the name when searching for a drug in the ADC system. Omnicell now supports this 5-character search functionality, which provides added security to prevent practitioners from inadvertently selecting the wrong medication that can lead to patient harm. Pharmacy can configure the settings for each cabinet to require users to enter the first five characters of a drug name before results are populated in the search field.

Reporting and analytics are an essential component of any medication safety system. Errors and close calls should be reported and analyzed through a root cause analysis to identify the cause and develop measures to prevent similar occurrences. Omnicell cabinets provide robust data analytics and intelligence dashboards to help pharmacy maintain visibility to medication inventory and potential diversion. These dashboards can be used to automate the publication of monthly reports which can then be shared with nursing leads, as recommended by ISMP.

Watch this webinar to learn more about how automated dispensing systems support ISMP guidelines for medication safety.


The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.

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