PILAR Comparison between manual and automated processes in the preparation of intravenous mixtures

Background Automated systems have shown increased efficiency and safety in preparation processes and quality control of intravenous mixtures (IVMs). Purpose To evaluate the differences, in terms of efficiency and safety, between manual and automated processes in the preparation and quality control of IVMs. Materials and methods Comparative descriptive study of manual versus automated IVMs preparation (IV Station robotic system). The procedures for the manual workflow and the automated system were compared. Quality control procedures for the final product were also compared. Results The manual process comprises five stages: 1) Preparing the relevant material (eg, drugs, solvents, consumables, packaging material) 2) Checking the material gathered 3) IVM production (following the relevant standard operating procedure) 4) Packaging and labelling of the final product 5) Quality control of the final product by a different member of staff: drug and solvent (name, volume), label (patient, drug and dosage, solvents, volume, infusion rate, storage conditions, batch, expiry date, visual inspection, packaging). The automated process includes five stages: 1) Preparing the materials specified in a software-generated list 2) Loading and automatic material checking by optical recognition and barcode checks 3) IVMs preparation and gravimetric control of intermediate components (eg, vials) and final product through a robot-integrated precision balance 4) Automatic labelling and downloading of final product 5) Label check and visual inspection of final product by nursing staff. Conclusions Although preliminary results show the same number of steps for both processes, the robotic system achieves 60% automation of the quality control. Optical and barcode recognition, gravimetric control and automated labelling represent the main advantages of the robotic system compared with the manual preparation and also the best guarantees for the IVMs production process. Robotic systems give added value to production in terms of efficiency and safety.