In closed loop medication management, the goal is to get five out of five right

The core idea of closed loop medication management is to carry out the administration of medication in a way that ensures that the following five objectives are always met: the right medication, the right dose, the right patient, the right time and the right route.

The process is based on effective cooperation between people and automated systems and on the counterchecking of the different stages of medication administration. One of the key elements that can contribute to a well-designed closed loop medication management process is an automated dispensing cabinet.

According to Oulu Universty Hospital Medication Education and Safety Coordinator Sami Sneck, there are several effective ways to implement a closed loop medication management process. Yet, regardless of the implementation, the planning of this process should always focus on the issuing of the prescription, the procurement, distribution and preparation of the medication, the administration of the medication and the recording of the administration.

“Often challenges arise as early as when issuing the prescription. In an ideal situation, a doctor’s decision-making process would always be supported by an electronic system that could immediately take into consideration patient’s drug allergies and other medication,” Sneck describes.

In an example case, the prescription issued by a doctor is counterchecked by a nurse or a pharmacist, after which the order is sent directly to the pharmacy. The pharmacy carries out dose distribution, which is automated as far as it possible, after which the medication is delivered to the hospital ward in patient-specific doses.

An automated dispensing cabinet supports the process

The automated dispensing cabinet’s role in the closed loop medication management process is to support the distribution of medication to patients. Not all medication is delivered directly to the ward from the hospital pharmacy; instead, the medication is retrieved from an automated dispensing cabinet by a nurse. Provided that the information systems are harmonised, the automated dispensing cabinet can replicate the original prescription and steer the nurse’s actions by requiring that the administration of the medication be recorded, for example.

“An automated dispensing cabinet is essential when medication is distributed manually. It supports the work of nurses while also increasing safety. The next step is to ensure the identification of the right patient with the help of patient´s barcoded wristband, for example. Once the medicine has been administered to the patient, the process loops back to the beginning,” explains Sneck.

A closed loop process is a common goal

In April, Sneck gave a talk on the closed loop medication management process at a meeting for hospital pharmacists organised by NewIcon.

“The challenges are the same everywhere. Planning a closed loop process is not easy due to the fact that there are dozens of existing systems currently in use, not to mention the fact that it requires the harmonisation of different interfaces. However, based on the discussion we had at the event, I remain positive. The attending experts from all over Finland clearly have a common goal to implement a closed loop process for medication management,” Sneck rejoices.

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