Posted on Wednesday November 18 2015 by RIG Healthcare
I am a pharmacy technician working in an aseptic production unit and this is (hopefully) the first of many blogs! In my unit we work with a Baxter EM2400 compounder where we make PN for home patients. This is a brilliant machine that makes the manufacture of custom made PN a lot easier than manually manufacturing, but is there a down side to using this?
For those who have not seen or used an EM2400 before it is a compounder that draws through the required volume of liquid as specified by the user. It then weighs the bag and issues a Mix check report which details whether the resulting bag is within the weight limits (hence it contains to correct amount of ingredients).
Once set up, this can save a tremendous amount of time with even large volume bags (some we make are 4000ml) running through in less than 10 minutes. We have included the use of micro ingredients within this so you can simply add trace elements and vitamins if required. This length of time (as production based techs/pharmacists will know) is extremely quick and allows for a larger volume of bags to be made. This also allows incredible flexibility for patients who require PN. You can add in almost any volume of the ingredients programmed on the compounder (minimum volumes are applicable but these are very small) meaning that customising bags to patients specific needs is easy and achievable. We have also used the barcode scanning feature of the EM2400 to allow us to actually programme patient’s regimens onto the compounder just meaning we scan the barcode and the bag fills. This can cut errors dramatically as no individual user input is needed and all regimens that are added to the compounder are accuracy checked by at least two pharmacists.
From the surface this all seems to be an extremely positive use of technology in the pharmacy industry. However, we have encountered potential problems with this piece of equipment. One such problem is (as with any piece of technology!) that there can be unexplained problems that are not easily solved. Whilst there are guides and procedures in place to deal with most problems, sometimes computers just do not want to play ball and we need to make sure that there are contingency plans that are in place.
The main problem/worry is that we are de-skilling our workers. Where, when using the machine, you are essentially scanning a barcode and letting the machine work. In an area like aseptics, we rely heavily on the quality of the people who we employ in the unit and that they work vigilantly to ensure our products are of the highest quality. The concern is that with the autonomous process we are encouraging relaxed behaviour in the unit. It is also concerning that if something happens to the compounder and manual PN is needed to be made, the staff may not have the skill set needed in order to manufacture these products.
All in all, we find the use of this piece of equipment advantageous, but being extremely well prepared and having staff fully trained for worst case scenarios is essential when investing in a compounder of any kind.
What are your thoughts?
by Stephen Sheehan
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