Evaluating Tabletop PackagersNow that unit dose packaging of medications isacknowledged to be the most economical andefficient method of dispensing in health care set-tings, hospitals have to make the decision onhow best to accomplish this process. In an idealworld, this would be accomplished by findingpharmaceutical manufacturers that offer unitdose packaging with a bar code on each labelfor bedside verification.

A second option would be to look at compa-nies that repackage bulk medications into unitdose packaging. This scenario would require anin-depth analysis of the cost, transportation, andquality control considerations.

A third alternative is to explore in-houserepackaging. This option requires careful con-sideration of the unit dose equipment to be pur-chased, and a list of requirements based on theneeds of the facility should be drawn up.Optimally, this discussion should involve a crosssection of the staff, including pharmacists, tech-nicians, and nursing representatives.

Developing Criteria for Purchasing Equipment Your team should consider the following:

Cost• Budget for purchasing the machinery• Cost of supplies, including work benches

and tables• Additional costs for computer hardware

that may be needed to operate the machines

Space Requirements• Space available to isolate the equipment so

operators are not easily distracted, but read-ily accessible for checking by pharmacistsbefore being placed in inventory

• Security, since controlled substances willhave to be unit dosed

Staffing • Availability of sufficient F.T.E.’s to operate

the equipment safely• Designation of employees who are respon-

sible for the operation and for the preven-

tive maintenance, imperative to minimizedown time

• Responsibility for writing the policy and pro-cedures for the operation of the machinery

Training and Support• Training and support offered by equipment

manufacturer, including follow-up supportand technical advice (inevitably humanerror will cause problems shortly after thetrainers leave)

In addition, develop questions about the specificneeds of your institution that can differentiateequipment, for example:

• Is a bar code necessary? Is the facility usinga bedside verification process or will it be inthe foreseeable future?

• What will be the back-up plan if the machine isnot functional?

• Is there a need to unitdose other forms of medications like vials,ampoules, syringes, oral liquids? Are thereother needs specific to the facility? Forexample, does the facility have Omnicellcabinets that require a package small enoughto be loaded into the cassettes and still dropfreely when dispensed?

Finding Equipment to Meet Your NeedsDifferent brands of unit dose systems may havebenefits or drawbacks, depending on the needsyou’ve established.

For example, once the scope of the type ofdrugs to be unit dose packaged has been deter-mined, you will want to consider which equip-ment is appropriate for your needs. MedicalPackaging, Inc. (MPI) has been around for some30 years, and, if space is critical, its Auto-PrintII system has the advantage of being the mostcompact of the automated systems for packag-ing oral solid products. The machine packages

the oral solids in a perforated single strip that isemitted to the side of the machine. The operatorshould be alert to keep the strip free from jam-ming. The optional Autopak MDD Autofeederis now available for the Auto-PrintII.

Accu-Chart, Inc. (Euclid) also has a wide vari-ety of machines. Its standard Cadet produces asingle strip of packaged drugs. The Twin Cadetproduces a strip that is two drugs wide, and canbe outfitted to accept a smaller sized packagingstrip. If you do use the Omnicell automated dis-pensing system, the smaller size version of theTwin will work with the Omnicell cassettes witha slight modification to the cassette itself. TheCadets discharge the finished packages down-ward, so the counter must have a hole cut andthere needs to be clearance below to capture the

finished product. A recommendation would beto secure the machine, so that an inadvertentbump does not affect the alignment of themachine and the hole. If the completed packagesback up it will cause the system to jam.

Additionally, both MPI and Accu-Chart, Inc.offer liquid unit dose packagers and overlay-packaging machines to provide a barcode forvirtually every other dosage form.

Automed’s tabletop has an optional AutoPacautomatic feeding system that allows for contin-uous packaging. In addition, the feed is horizon-tal, not vertical, which avoids crushed pills andkeeps heat away from gel caps.

You will also want to consider back-upoptions for that inevitable down time. Oneoption to consider is a manual packaging systemwith computer-generated labels. Medi-Doseoffers such systems, and the initial cost isextremely low in comparison to the other com-petitors, making them advantageous as a man-ual emergency back-up in those facilities withautomated machinery, or for institutions thatrequire small quantities to be packaged.

If staffing is a consideration, Pearson’s

You will also want to consider back-upoptions for that inevitable downtime.

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By Sheldon Lefkowitz, RPh, MS, and Jeffrey Spicer, BS, MBA

Exclusive PP&P feature

Intellipack has a feature that allows hands freeoperation. Once the information is loaded intothe computer for the label, the pills are emptiedinto the hopper and the process begins, leavingthe operator free to continue other chores.Pearson is also willing to modify their equipmentto meet demands for different size packaging.Another standard feature is their M-print soft-ware, which scans the bulk bottle’s bar code, andthen using First Data Bank information populatesthe label screen. This eliminates human error thatcan occur when manually filling in label screens.This software also allows the customization ofthe label format to fit your facility’s requirements.The M-print software is also available for use onthe other brands of equipment.

Once you have a clear senseof your requirements and havepinpointed equipment that fit

these requirements, it is important to evaluatethe systems in action. As you can see, the choiceof unit dose machinery should not be takenlightly. Both demonstrations at your site and vis-its to a nearby a facility which has the machin-ery that you are considering are very beneficial.

Sheldon Lefkowitz, RPh, MS. is Director ofPharmacy Services at St. Mary’s Hospital inWest Palm Beach, Florida.Jeffrey Spicer, BS, MBA Is an Adjunct Professorat Indian River Community College in FortPierce, Florida.

For more information, circle #20 on the Reader Service Card

Where to find it:

Medical Packaging, Inc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.medpak.com

Accuchart . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.accuchart.com

MediDose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.medi-dose.com

Pearson Medical Technologies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.pearsonmedical.com

Automed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . www.automedrx.com

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