Improving the medication-use process for 23.4% sodium chloride.

Area of Science:

• Pharmacy practice
• Medication safety
• Hospital formulary management

Background:

• 23.4% sodium chloride injection is a high-alert medication requiring specialized handling.
• Traditional distribution methods may pose risks.
• Automated dispensing cabinets (ADCs) offer potential for improved medication management.

Purpose of the Study:

• To evaluate medication storage, distribution, and safety outcomes of 23.4% sodium chloride injection.
• To assess a novel distribution process with safeguards for urgent medication removal from ADCs.
• To determine the safety and efficiency of storing and dispensing this medication via ADCs.

Main Methods:

• Retrospective review of 70 administered doses of 23.4% sodium chloride injection over 38 months.
• Analysis of times from order entry to pharmacist verification, dispensing, and administration.
• Evaluation of adverse events related to dispensing and administration.
• Assessment of ADC override function usage for urgent removals.

Main Results:

• Mean times from order entry to verification, ADC removal, and administration were 8, 25, and 43 minutes without ADC override.
• With ADC override, 16 of 30 doses were removed via override, with retrospective order entry for 9.
• No documented adverse events related to medication distribution; 2 possible adverse effects from administration.

Conclusions:

• Novel storage and distribution processes for 23.4% sodium chloride injection enhance medication safety.
• Maintaining this high-alert medication in ADCs is a safe and efficient practice.
• The implemented safeguards support optimized medication-use processes.