Impact of Anticipatory Batching of Pharmacy Compounded Sterile Products on Time to Nurse Administration

Abstract

Background: Timely medication administration is integral to patient care, and operational delays can challenge timely administration. Within an inpatient pharmacy of an academic medical center, intravenous medications were historically compounded on a patient-specific basis. In 2020, the pharmacy began batching frequently-utilized medications. This analysis explored the impact of compounded sterile batching on pharmacy and nursing services. Methods: This pre- and post-interventional study compared data from February through March 2020 with a seasonally matched period from 2019. The primary endpoint was difference in time to administration of urgent (STAT) medications. Secondary endpoints included timeframes for a pharmacy technician to prepare, a pharmacist to check, and a nurse to administer the medications, as well as reprinted labels and estimated waste. Results: On average, it took one hour and 43 minutes to administer a STAT medication in 2019 and one hour and 57 minutes in 2020 ( p = 0.122). It took about four hours to administer routine medications in 2019 and 2020 ( p = 0.488). The number of labels reprinted decreased from 616 in 2019 to 549 in 2020 ( p = 0.195), relating to decreased missing doses. The mean time to check and send a medication decreased from 2019 to 2020 for STAT orders ( p < 0.001), and there was no difference in wasted medications looking at all orders in this time. Conclusion: Anticipatory batching decreased time to prepare, check, and send medications, though there was no effect on waste or on time to administration. Future studies can examine the correlation between pharmacy operations and medication administration.