Survey of Hospital Pharmacy Directors: Assessment of the Current State of Unit-Dose Acquisition

Abstract

Background: Many hospitals are in the planning stage of barcode point-of-care (BPOC) implementation. One of the challenges that hospital pharmacies face in BPOC implementation is unit-dose acquisition. Objective: This article presents the results of a survey of hospital pharmacy directors to assess the current state of unit-dose acquisition to support bedside barcode-enabled dispensing practices. Methods: An online survey was administered over 2 months and was available from September to November 2008. The University of Arkansas Institutional Review Board approved the survey before it was disseminated. The survey was developed in collaboration with 2 hospital pharmacy directors. Ninety-one valid survey responses were representative in terms of the distribution of hospital size compared with previous surveys of the American Society of Health-System Pharmacists. Though there were 91 total respondents, not all provided responses to all of the survey questions. Thus, some of the figures, tables, and text refer to fewer than 91 respondents. Results: The results of interest to pharmacy technicians indicated that most hospitals today are able to purchase at least 40% of their medications in unit-dose packaging directly from the manufacturer. For medications that cannot be acquired in unit-dose packaging, 85% of the hospitals surveyed perform repackaging operations in-house. However, 87% of the hospitals that use a high-speed oral solid repackager only use this equipment, at most, 4 hours per day. Our survey results showed that only 8% of the hospitals surveyed used a third-party repackager to acquire unit-dose medications, compared with 85% of hospitals that are either currently using or in the planning phase of using BPOC. Conclusions: The survey found that most hospital pharmacy directors choose to repackage medications in-house, despite the high cost of repackaging equipment and a relatively low utilization of that equipment. Hospitals indicated that cost and turnaround time were the 2 issues of greatest concern when considering outsourcing unit-dose medication repackaging to a third-party repackager.