Nurses\xb4 perceptions of automated dispensing cabinets \u2013 an observational study and an online survey

Riikka Metsämuuronen,Toivo Naaranlahti,Minna Kurttila,Hannu Kokki,Reeta Heikkilä

doi:10.1186/s12912-020-00420-2

Riikka Metsämuuronen, Toivo Naaranlahti + Show 3 more

Open Access

https://doi.org/10.1186/s12912-020-00420-2

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Abstract

BackgroundThirty-two automated dispensing cabinets (ADCs) were introduced in May 2015 in Kuopio University Hospital, Finland. These medication distribution systems represent relatively new technology in Europe and are aimed at rationalising the medication process and improving patient safety. Nurses are the end-users of ADCs, and it is therefore important to survey their perceptions of ADCs. Our aim was to investigate nurses’ perceptions of ADCs and the impacts of ADCs on nurses’ work.MethodsThe study was conducted in the Anaesthesia and Surgical Unit (OR) and Intensive Care Unit (ICU), of a tertiary care hospital, in Finland. We used two different research methods: observation and a survey. The observational study consisted of two 5-day observation periods in both units, one before (2014) and the other after (2016) the introduction of ADCs. An online questionnaire was distributed to 346 nurses in April 2017. The data were analysed using descriptive statistics including frequencies and percentages and the Chi-Square test.ResultsThe majority (n = 68) of the 81 respondents were satisfied with ADCs. Attitudes to ADCs were more positive in the ICU than in the OR. Nearly 80% of the nurses in the ICU and 42% in the OR found that ADCs make their work easier. The observational study revealed that in the OR, time spent on dispensing and preparing medications decreased on average by 32 min per 8-h shift and more time was spent on direct patient care activities. The need to collect medicines from outside the operating theatre during an operation was less after the introduction of ADCs than before that. Some resistance to change was observed in the OR in the form of non-compliance with some instructions; nurses took medicines from ADCs when someone else was logged in and the barcode was not always used. The results of the survey support these findings.ConclusionsOverall, nurses were satisfied with ADCs and stated that they make their work easier. In the ICU, nurses were more satisfied with ADCs and complied with the instructions better than the nurses in the OR. One reason for that can be the more extensive pilot period in the ICU.

Highlights

Thirty-two automated dispensing cabinets (ADCs) were introduced in May 2015 in Kuopio University Hospital, Finland
In 2014, the nurses under observation collected the medicines or solutions from outside the operating theatre during the operation in seven out of eleven (64%) operations observed, whereas in 2016 the figure was in only one operation out of eight (13%)
The nurses were satisfied with ADCs and expressed they have made their work easier

Summary

Introduction

Thirty-two automated dispensing cabinets (ADCs) were introduced in May 2015 in Kuopio University Hospital, Finland These medication distribution systems represent relatively new technology in Europe and are aimed at rationalising the medication process and improving patient safety. ADCs, were introduced in the 1980s in the United States, since which time they have been increasingly used to automate and rationalise the medication process in hospitals and other health care facilities [1]. These medication storage systems decentralise the distribution of drugs near the patient and provide quick access to medicines for the nurse. ADCs can help to account for medicine, billing and inventory management

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