Better ergonomics was the primary motive for procurement

Published 20th of October 2017

A little over a year ago, the pharmaceutical services at the Central Finland Central Hospital took a technological leap as the IV ICON Twins robot started preparing antibiotics. This eliminated an ergonomically straining task and enabled the hospital to increase production levels according to the increased needs at the hospital. The introduction of automation into the everyday operations required rethinking the whole process.

Preparing antibiotics manually is a time-consuming and ergonomically burdening task. It was decided in the Central Finland Central Hospital that they wanted to minimise the disadvantages and risks connected to the dilution of antibiotics.

“We wanted to increase the efficiency of the whole work process using automation, but improving the ergonomics was our number one priority. In manual labour, using the key pinch grip and twisting wrists repeatedly when drawing antibiotics from bottles puts an excessive strain on hands and shoulders,” leading pharmacist Anna Vilanti explains.    

Medicines are prepared outside of the wards

Often there are no suitable rooms for aseptic preparation of medicines in the ward pharmacies, particularly in the case of larger batches. In addition to improved asepsis, another goal in Jyväskylä was to improve the nurses’ work in the case of the most commonly used antibiotics, cefuroxime.  

Thanks to automation, preparation is faster, safer and more ergonomic. This also avoids exposure to antimicrobial dust.

“This is why we have already prepared cefuroxime in the hospital pharmacy for a long time. Automation makes larger production batches possible and produces medicines with a higher microbiological quality,” Ms Vilanti explains.

Another benefit is the improved time efficiency.

“It takes a moment to prepare the robot so it makes sense to prepare larger batches at a time. After the initial preparations, when the robot is performing a run, we can make use of the time by loading new product palettes and unloading previous ones. This eliminates the need for unnecessary waiting,” she adds.  

Extensive validation to guarantee quality

In the Central Finland Central Hospital, the quality of operations is constantly being improved. For the preparation of medicines, a standardised and validated preparation process has been created to monitor both the microbiological quality of the medicine and the accuracy of the doses. Automation further simplifies quality control as the preconfigured robot adds the dissolvent to the dry powder antibiotic, accurately dissolving it into a homogenous solution that is ready for use.

In connection with the commissioning of the device in Jyväskylä, both the device and process were validated extensively. Some adjustments were required for accurate dosing. However, when it was configured correctly, the accuracy was on a very high level. Twins can normally reach a measurement accuracy of +/- 2.5%. The commissioning also led to other insights as a kind of a by-product of the process.

“We noticed that the sealing of the puncture holes in the rubber caps on the bottles took a considerable amount of time. To solve this, we discovered a sealing label that is easier to apply, considerably speeding up the whole process,” Ms Vilanti says.

“The robot prepares the cefuroxime faster than people do, but the labelling that is still done manually takes up a lot of time. However, the robot has made it possible for us to prepare antibiotics for a larger number of customers using the same amount of staff,” hospital pharmacist Kirsi Juurinen explains.

Standardised doses processed by the robot

Together with the rest of the world, the operating environment of hospitals and pharmacies is changing. Using technology for routine tasks is becoming increasingly common, and the roles of the personnel evolve accordingly. It requires that the staff keep an open mind and want to learn new ways of working. What are leading pharmacist Anna Vilanti’s views on a future hospital pharmacy?

“Generally I think that the task of a hospital pharmacy is to serve the hospital units as best as it can, to minimise the number of pharmaceutical service tasks that nurses have to take care of. This way, they can concentrate even more on working with patients,” she summarises.

Concentrating functions nearly always results in benefits and the operation becomes more efficient.

“The pharmacy hopes to be able to considerably extend the preparation of antibiotics using automation. The benefits of automation are particularly clear in preparing standardised doses.”  

According to Anna Vilanti, the IV ICON Twins provided a good first experience in commissioning an automation device. The staff is now familiar with it, meaning they will also be able to handle any future commissionings with confidence.

“When planning the automation process, we looked at the entire working process again and developed a new way of working. It has been a learning curve and we have come across some small challenges as well, but we have been able to resolve any and all issues and everything has gone surprisingly well. After all, the operating principle of the device is simple.”