Observations on the use of ready-to-use and point-of-care activated parenteral products in automated dispensing cabinets in U.S. hospitals

The use of ready-to-use (RTU) and point-of-care (POC) activated parenteral products and their storage in automated dispensing cabinets (ADCs) in U.S. hospitals were evaluated. A survey on the use of RTU and POC activated parenteral products, including storage and dispensing of the products, was developed and sent electronically to hospital pharmacy administrators. Survey respondents were identified using the American Society of Health-System Pharmacists' member database. Of the 4070 surveys sent, 965 (23.7%) were completed and returned. Most pharmacy administrators (94.7%) reported that their institution used some form of RTU and POC activated parenteral product, with 74% using ADCs to dispense these products. Efficiency was the most common reason cited for storage of RTU and POC activated products in ADCs. Facilities varied on reasons for not implementing this technology, with 47 facilities citing implementation costs, limited number of RTU and POC activated products on the hospital's formulary, lack of available pediatric formulations, and safety concerns as the main reasons. More than half of respondents noted space limitations as the greatest challenge to adding RTU and POC activated products to ADCs. Nearly three fourths of survey respondents reported using RTU and POC products in conjunction with ADCs; however, the approach to including these products in ADCs varied based on the characteristics, policies, and preferences of the individual facility. Advantages of RTU and POC products identified by respondents included enhanced safety benefits, increased dispensing efficiency, cost avoidance due to reduced waste, and improved compliance with federal and state regulations.