Medication-related nursing time in centralized and decentralized drug distribution

The amount of time spent by nursing personnel in medication-related activities was evaluated in a centralized and a decentralized drug-distribution system. A work-sampling study was used to measure the amount of time spent by nursing personnel in various work activities before and after establishing a satellite pharmacy. Random observations of three nurses and a transcriber were made daily for five-day periods one month before and two months after the satellite pharmacy became operational. The actual number of hours worked by nursing personnel and the patient census during both study periods were also recorded. The lag time for order processing and distribution of initial doses and the accuracy of filling unit dose cassettes were measured in both drug-distribution systems. Nurses' attitudes toward the decentralized system were surveyed three months after implementation of the satellite pharmacy. The percentage of time nurses spent in medication-related activities was significantly less in the decentralized system. Actual hours spent in medication-related activities per patient day were also less in the decentralized system. Lag time for order processing decreased from 55.3 minutes in the centralized system to 15.2 minutes in the decentralized system. The number of unit dose dispensing errors per patient day also decreased after implementing the pharmacy satellite. All nurses surveyed favored the decentralized system. Decentralized drug distribution using a satellite pharmacy was associated with more efficient use of nursing time compared with centralized drug distribution.