A Unique Decentralized Unit Dose Project

Abstract

This paper describes a decentralized unit dose project at University Hospitals, in Madison, Wisconsin, initiated on July 6, 1965 and terminated on September 4, 1965. A total of 13,766 doses were administered during the 2,453 patient days involved. Initially, a pharmacist was stationed on only one nursing unit. Two additional units were later included. No mechanical means of communication, transportation, or packaging were used. The pharmacist involved transcribed each order directly from the physician’s order book. All trays were set on the unit by the pharmacist; however, much of the unit dose packaging was done centrally. The pharmacist was responsible from the moment the order was written until he received the empty container from the nurse who administered the dose. Complete patient medication records, which included notation of any drug reactions, were kept by the pharmacist. The pharmacist was responsible for the ordering of all supplies, with the exception of blood and linen, for the units involved. The project was successful. Patients received improved pharmaceutical service while nurses had more available time for patient care. Pharmacists and nurses expressed the opinion that at least a month of acclimation was necessary to feel at ease with the system. Decentralized unit dose pharmaceutical service is feasible and the authors believe that it is the distribution system of choice.