Healthy water is our prime demand however population explosion and industrialization have threatened the quality of water. Consequently, about a billion people in developing countries including Iran ...are struggling for a safe and sustainable water supply. Timely water sampling and analyses are critical to access and maintain healthy status. The current study investigates the state of water supply in 29 villages of Sahneh town and provides recommendations for maintaining good health. Water samples were extensively analyzed for the physical and chemical indexes using the EPA standards and the Iran national water standards (Table S1). The mean of pH, total dissolve solid, electrical conductivity, chloride concentration, sulfate, temperature, bicarbonate, total alkalinity, calcium hardness was 8.2, 326.5 mg/L, 422.4 mS/cm, 203 mg/L, 6.4 mg/L, 24.7 °C, 257.2 mg/L, 210.9 mg/L as CaCO3, 233.8 mg/L CaCO3, respectively that are within the permitted limit. Interactions between these factors were statistically analyzed to characterize the water samples. All sampled waters were probable to sediment according to the Langelier index (0.67 ± 0.20), corrosive according to aggressiveness (10.74 ± 0.40) and Puckhorius indexes (6.96 ± 0.63). Water samples also exhibited scaling therefore it is recommended to use cemented pipes for dispensing networks. Moreover, balancing pH, alkalinity, calcium levels and annual testing by the government should be considered to promote good health.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•The replenishment process is crucial to performance in central fill pharmacies.•A continuous-time Markov Chain models the stochastic behavior of replenishment.•Developed Markov Chain can be ...appropriately used to analyze replenishment process.•Reorder point, canister size, number of operators can be optimized to reduce cost.•Proposed approach can be extended to large-scale dispensing systems.
This study focuses on the replenishment process of the robotic dispensing system (RDS) in a central fill pharmacy (CFP). The RDS is capable of autonomously counting and filling tens of thousands of prescription orders each day while being replenished by operators. If the replenishment is not completed on time and the dispenser becomes empty while orders continue to arrive, the RDS will experience a problem called a rundry error and cannot fill orders until the replenishment is complete. Because rundry errors significantly degrade the performance of CFPs, there is an urgent need to analyze and understand the replenishment process of the RDS to prevent these errors. The main objective of this study is to develop a systematic approach to model the stochastic behavior of the replenishment process by using a continuous-time Markov Chain and to find the optimal reorder point (ROP), canister size, and the number of operators that minimize the replenishment costs. Numerical experiment results show that ROP, canister size, and the number of operators have a significant effect on the performance of the RDS. In the dispenser analyzed in this study, increasing the ROP from 0.5 to 0.5 led to a 26.7% reduction in downtime and a 49.2% reduction in total costs. Similarly, Increasing the canister size from a 0.5-L canister to a 2-L canister led to a 10.5% reduction in downtime and a 69.5% reduction in total costs. The results show that the proposed approach can be used to optimize the replenishment process to minimize cost.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Display omitted
Dissolving microneedle arrays (dMNAs) are promising devices for intradermal vaccine delivery. The aim of this study was to develop a reproducible fabrication method for dMNAs based on ...an automated nano-droplet dispensing system that minimizes antigen waste. First, a polymer formulation was selected to dispense sufficiently small droplets (<18 nL) that can enter the microneedle cavities (base diameter 330 µm). Besides, three linear stages were assembled to align the dispenser with the cavities, and a vacuum chamber was designed to fill the cavities with dispensed droplets without entrapped air. Lastly, the dispenser and stages were incorporated to build a fully automated system. To examine the function of dMNAs as a vaccine carrier, ovalbumin was loaded in dMNAs by dispensing a mixture of ovalbumin and polymer formulation, followed by determining the ovalbumin loading and release into the skin. The results demonstrate that functional dMNAs which can deliver antigen into the skin were successfully fabricated via the automatic fabrication system, and hardly any antigen waste was encountered. Compared to the method that centrifuges the mould, it resulted in a 98.5% volume reduction of antigen/polymer solution and a day shorter production time. This system has potential for scale-up of manufacturing to an industrial scale.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Rationale, aims and objectives
Implementation of robotic systems in outpatient hospital pharmacies is uncommon. Other than cost, 1 of the barriers to widespread adoption is the lack of definitive ...evidence that this technology actually reduces dispensing errors and improves inventory management.
Objective
To identify the frequency of medication dispensing errors before and after the implementation of a robotic original pack dispensing system in an outpatient hospital pharmacy and to analyse the impact of this system on the quality of stock management and staff satisfaction.
Methods
A prospective before‐and‐after medication error study was performed using a disguised observation technique. Several indicators of stock management and staff satisfaction were monitored.
Drugs were dispensed manually by technicians using a barcode‐controlled system (preimplementation phase) or the dispensing robot ROWA Vmax (ARX) (postimplementation phase). As not all drugs could be handled by the robot, residual manual dispensing was also used.
Results
The dispensing error rate was reduced from 1.31% of prescriptions (43/3284) to 0.63% (19/3004) (relative risk reduction RRR, 51.7%; 95% CI, 17.3% to 71.8%). The error rate decreased up to 0.12% (3/2496) (RRR, 90.8%; 95% CI, 70.4% to 97.1%) if errors during residual manual dispensing were excluded. The stock‐out ratio was reduced from 0.85% to 0.17% (RRR, 80.5%; 95% CI, 49.5% to 92.5%). Daily staff time (median) in stock management was reduced by 59.3% (from 1 hour 36 minutes to 39 minutes). High level of staff satisfaction with this technology was achieved, although it was slightly higher in the group of pharmacists compared to technicians (8.63 ± 0.7 vs 7.78 ± 0.7, P = .046).
Conclusion
The implementation of a robotic original pack dispensing system substantially decreased the rate of dispensing errors and optimized stock management. Minimizing the number of drugs out of the dispensing robot is critical when attempting to maximize the benefits of its implementation.
Full text
Available for:
DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
In the present work, a new delivery and dispensing system for root crops is developed. This system prepares the vegetables for subsequent processing. The dependence of the system’s energy parameters ...and the rheological properties of the feed produced on the design parameters is established analytically.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Abstract
Objectives
To evaluate the return on investment (ROI) and quality improvement after implementation of a centralized automated-dispensing system after 8 years of use.
Design
Prospective ...evaluation of ROI; before and after study to evaluate dispensing errors; user satisfaction questionnaire after 8 years of use.
Setting
The study was conducted at a French teaching hospital in the pharmacy department, which is equipped with decentralized automated medication cabinets in the wards.
Participants
Pharmacy staff (technicians and residents).
Intervention(s)
Implementation of a centralized automated-dispensing robot.
Main Outcome Measure(s)
The true ROI was prospectively and annually compared to estimated returns calculated after implementation and upgrade of the robot; dispensing errors determined by observation of global deliveries and the satisfaction of users based on a validated questionnaire were evaluated.
Results
Following the upgrade, we found little difference for the ROI (+1.86%). The payback period increased by almost 3 years. There was a significant reduction of dispensing errors, from 2.9% to 1.7% (P < 0.001). User satisfaction of the robot by the pharmacy staff was reported (score of 5.52 ± 1.20 out of 7).
Conclusions
These systems are worthwhile investments and largely contribute to improving the quality and safety of the medication process.
Full text
Available for:
BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Objectives:
This article describes the implementation of an automated medication dispensing system (AMDS) in Eswatini to increase medication access and presents the early lessons from this ...implementation.
Methods:
The AMDS was installed at four health facilities across two regions through collaborative stakeholder engagement. Healthcare workers were trained, and clients who met the inclusion criteria accessed their medications from the system. Each step of the implementation was documented and summarised in this article.
Results:
Early lessons suggest that implementation of the AMDS is acceptable and feasible to clients and healthcare workers and that phased introduction of medication classes, commencing with antiretroviral therapy (ART) and incorporating other medications in later phases is feasible. Additionally, improved client-centred messaging and communication, consistent power supply and internet network connectivity, and scheduling medication pickup with other services increase AMDS system utilisation.
Conclusion:
Eswatini has many clients living with HIV and non-communicable diseases (NCDs). Easy, convenient, quick, non-stigmatising and client-centred access to ART and medication for NCDs is critical in addressing retention in care and achieving optimal treatment outcomes.
•Knowledge is discovered from mining prescriptions’ database.•Association rule mining is used to capture the associations among drugs.•Patterns in drug dispensing are analyzed.•Improved planogram ...designs for pharmacy automation systems are provided.
Automation in pharmacies has achieved innovative levels of effectiveness and savings. In the present day, automated pharmacies are facing extremely large demands of prescription orders specifically at the central fill pharmacies that distribute drugs to retail pharmacies. As a result, improvements are necessary to the Robotic Prescription Dispensing System (RPDS) and RPDS planogram to increase the throughput of prescriptions. RPDS planogram defines where to allocate the dispensers inside the robotic unit and how to distribute them among the multiple robotic units. This research utilizes the pharmacy prescriptions database to extract useful knowledge to improve different strategies in pharmacy automation by using a data mining approach. In this study, a data mining tool is proposed to enhance pharmacy automation. Frequent Pattern Growth (FP-growth) approach, which is one of the algorithms of Association Rule Mining (ARM), is applied to an actual prescriptions database of a central fill pharmacy to study the associations within the prescribed drug regime. The FP-growth application in a prescriptions database is novel; thus, FP-growth is tested on both sequential mode, and parallel mode by using a distributed platform Hadoop and MapReduce paradigm. Two types of association rules are extracted: 1) associations among different drugs that involve their different dosage strengths and manufacturers; and 2) associations that include only information about different drug generic and brand names. The importance of the extracted association rules is evaluated by the use of different measures, including the support, confidence, lift and conviction. The discovered rules disclose strong associations among the purchased drugs that improve the allocation and distribution of dispensers among the robotic units, in addition to enhancements in other pharmacy managerial strategies.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Objective
The purpose of our study was to evaluate the contribution of an automated drug dispensing system in securing cancer chemotherapy production process at the pharmacy of the National Institute ...of Oncology in Rabat.
Methods
The failure modes and effects analysis method was applied to the chemotherapy production process in two phases: Phase 1, using an open shelf for storage then phase 2, using an automated drug dispensing system. The failure modes were defined and their criticality indexes was calculated on the basis of the likelihood of occurrence, the potential severity for the patients and/or the impact on the process and the detection probability. The criticality indexes of the two phases were prioritized and compared.
Results
We identified 35 failure modes for phase 1 and 37 for phase 2. The sum of criticality indexes was 5957 and 4586, respectively, for phase 1 and phase 2, corresponding to a criticality reduction of −23%. The greatest improvements concerned that the needed drug is missing during the picking, storage of potential expired drugs, and double compounding.
Conclusion
Our study highlighted the contribution of automated drug dispensing system in risk minimization. The use of automated drug dispensing system is a part of security improvement in chemotherapy production unit.
Full text
Available for:
NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Supply chain digitalisation equipment's raise concerns for hospital decision-makers, especially regarding the cost-efficiency ratio, usually evaluated through health technologies assessments (HTA) at ...a national level or by return on investment (ROI) calculations by the hospital finance department. Unfortunately, none of the two methods identifies organisational impacts, nor hidden gains and costs, especially those that are related to the internal reallocation of resources as shows the example of automated dispensing systems (ADS) in the central pharmacy of a French hospital with a posteriori analysis from the hospital perspective. The introduction of the ADS caused some hidden costs or gains, which do not generate any financial flow and which are therefore not valued. When they are valued, as we do in this study by including them in the ROI calculation, the results change dramatically: the profitability of the investment goes from negative to positive. Given the importance of hidden gains and costs related to organisational impacts, they should be included in evaluations.
Full text
Available for:
BFBNIB, GIS, IJS, KISLJ, NUK, PNG, UL, UM, UPUK
PDF
