Patient Safety and Quality

Unit-Based Cabinets

Bar Codes, PINs and Fingerprint Scans Protect Patients from Medication Errors

The TUGs might get all the attention, but they're only part of the picture of how technology has changed the way medication is safely stored and accounted for at UMMC.

While the TUGs deliver specially-prepared drugs for a specific patient, computerized cabinets on each unit store and track the drugs most commonly administered, so that they are on hand when patients need them.

Most staff members at the Medical Center have become accustomed to referring to these cabinets by the manufacturer's name – Omnicell. There is an Omnicell cabinet in each pharmacy satellite and patient care area – more than 200 throughout the hospital – and each one is customized to meet the needs of that area for inventory, size and storage. The Pharmacy Services department provides 24-hour support for the technology.

The unit-based cabinets are equipped with a variety of safety features to promote safe medication use:

Only authorized and trained users can access medications from the cabinets by logging in via badge, manual password or fingerprint.
Each cabinet is linked to the pharmacy computer system in real time. A pharmacist must review and verify medication orders before a nurse can remove most medications. A perpetual inventory system alerts staff when to restock.
Software incorporates barcode scanning to ensure that the correct medication is restocked or dispensed.
Customized alerts – such as for "sound-alike-look-alike" medications – ask the clinicians to double-check in cases where errors are most likely to occur or where danger is high. For example, an alert reminds the clinician when a timed-release drug should not be crushed, chewed or split.
Nursing and pharmacy managers can generate reports to highlight areas that need improvement.

"The Omnicell helps the staff meet the challenge of administering medications in a safe and efficient manner," says Rita Herzog, MSN, CNRN, a nurse on Gudelsky 5.

"Implementation of unit-based cabinets at the Medical Center is a great example of using a safety strategy to make it easier for our caregivers to do the right thing," says Jonathan E. Gottlieb, MD, chief medical officer and senior vice president. "Medication administration is one of the most complex hospital processes, and creative use of technology like unit-based cabinets can allow us to perform complex tasks more reliably for every patient, every time."

This page was last updated on: December 1, 2010.