PURPOSE: To assess the comprehensive workflow and time and motion activities associated with hospital pharmacy and nursing staff for a cephalosporin antibiotic in 3 different marketed formulations: (1) a formulation prepared by traditional compounding, (2) a dual-chamber IV bag stored with prefilled diluent in the upper chamber and powdered drug in the lower chamber, and (3) a standard diluent container with an integrated drug vial adaptor that allows for drug admixture after connection to a single-dose powdered drug vial. METHODS: The study was conducted at 3 hospital locations from a single hospital network located in Arkansas. Study procedures were assessed by direct observations of pharmacists, pharmacy technicians, and nurses. Sequences and durations of tasks were observed to identify and document the actual time for each task. RESULTS: Approximately 402 observational hours of data collection occurred, with more than 100 formulated doses observed per formulation, with 98.6% overall study confidence. Use of the dual-chamber IV bag formulation resulted in a 63% decrease in labor time compared to traditional compounding. When comparing the dual-chamber IV bag formulation to the standard diluent formulation, there was about a 22% decrease in labor time. Based on the number of process steps, use of the dual-chamber formulation resulted in approximately 54% fewer opportunities for error versus traditional compounding and 35% fewer opportunities for error than use of the standard diluent formulation. CONCLUSION: Independent descriptive statistical analysis verified that the dual-chamber IV bag cephalosporin antibiotic formulation is a faster, simpler-to-use drug administration platform and associated with less chance of formulation and dosing errors.
Patel et al. (Tue,) studied this question.