Evaluation of two concurrent drug-delivery systems in a skilled-nursing facility

Traditional and modified traditional drug-delivery systems were compared in a 91-bed, two-floor, skilled-nursing facility. Both floors used a traditional system during the first study period. One of the floors then initiated a modified traditional (30-day card) system. Both floors were remeasured two months later for nursing time, pharmacist time, pharmacy-technician time, and error rates. Concordance data were obtained to determine in data-collection methods were reproducible. Savings expected from returnable 30-day cards were extrapolated from wasted medications collected. A significant decrease in nursing administration-time errors was observed on the modified floor, which may have been due to the modified traditional system. Pharmacist and pharmacy technician time were significantly increased by the modified-traditional system. Nursing time was not significantly altered. Potential savings from decreased waste was +677 per year. Nonetheless, the modified traditional system imposed an overall added cost of +942 annually, or approximately +0.24 per prescription. A cost-effective advantage was not demonstrated by the modified traditional system as compared with the traditional system.