A Modified Potency Test Strategy for IV Admixtures Prepared by Robotic Systems
Introduction: Robotic systems are increasingly used for compounding sterile IV admixtures (1-5). In addition to routine gravimetric checks, initial and periodic drug potency analysis by high-performance liquid chromatography (HPLC) is desired to verify the system accuracy. However, the conventional HPLC test procedures often result in unexpected failures (1-2). This study was initiated to develop a modified HPLC test strategy to eliminate the common source of variability and focus the effort on the accuracy of robotic system.
Impact of robotic antineoplastic preparation on safety, workflow, and costs.
PURPOSE
Antineoplastic preparation presents unique safety concerns and consumes significant pharmacy staff time and costs. Robotic antineoplastic and adjuvant medication compounding may provide incremental safety and efficiency advantages compared with standard pharmacy practices.


METHODS
We conducted a direct observation trial in an academic medical center pharmacy to compare the effects of usual/manual antineoplastic and adjuvant drug preparation (baseline period) with robotic preparation (intervention period). The primary outcomes were serious medication errors and staff safety events with the potential for harm of patients and staff, respectively. Secondary outcomes included medication accuracy determined by gravimetric techniques, medication preparation time, and the costs of both ancillary materials used during drug preparation and personnel time.


RESULTS
Among 1,421 and 972 observed medication preparations, we found nine (0.7%) and seven (0.7%) serious medication errors (P = .8) and 73 (5.1%) and 28 (2.9%) staff safety events (P = .007) in the baseline and intervention periods, respectively. Drugs failed accuracy measurements in 12.5% (23 of 184) and 0.9% (one of 110) of preparations in the baseline and intervention periods, respectively (P < .001). Mean drug preparation time increased by 47% when using the robot (P = .009). Labor costs were similar in both study periods, although the ancillary material costs decreased by 56% in the intervention period (P < .001).


CONCLUSION
Although robotically prepared antineoplastic and adjuvant medications did not reduce serious medication errors, both staff safety and accuracy of medication preparation were improved significantly. Future studies are necessary to address the overall cost effectiveness of these robotic implementations.
Energy
Energy is often defined as the ability to do work. There are many forms of energy. A few examples include; Gravitational energy, Kinetic energy (energy of motion), Thermal energy (heat energy), Potential energy. Potential energy is the energy something has based on its position in the universe. A stretched elastic band has potential energy. A rock held up in the air has potential energy based on its position.