Implementation of an Automated Dispensing Cabinet System and Its Impact on Drug Administration: Longitudinal Study
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Abstract
BACKGROUND: A technology that has been widely implemented in hospitals in the United States is the automated dispensing cabinet (ADC), which has been shown to reduce nurse drug administration errors and the time nurses spend administering drugs. OBJECTIVE: This study aimed to determine the impact of an ADC system on medication administration by nurses as well as safety before and after ADC implementation. METHODS: We conducted a 24-month-long longitudinal study at the National Taiwan University Hospital in Taipei, Taiwan. Clinical observations and questionnaires were used to evaluate the time differences in drug preparation, delivery, and returns in the inpatient ward by nurses before and after using the ADC. Drug errors recorded in the Medical Incident Events system were assessed the year before and after ADC implementation. RESULTS: The drug preparation time of the wards increased significantly (all P<.005). On average, 2 minutes of preparation time is needed for each patient. Only 1 unit showed an increase in the drug return time, but this was not significant. There were 9 (45%) adverse events during the drug administration phase, and 11 (55%) events occurred during the drug-dispensing phase. Although a decrease in the mean number of events reported was observed during the ADC implementation period, this difference was not significant. As for the questionnaire that were administered to the nurses, the overall mean score was 3.90; the highest score was for the item "I now spend less time waiting for medications that come from the pharmacy than before the ADC was implemented" (score=4.24). The item with the lowest score was "I have to wait in line to get my patient medications" (score=3.32). CONCLUSIONS: The nurses were generally satisfied with ADC use over the 9 months following complete implementation and integration of the system. It was acknowledged that the ADC offers benefits in terms of pharmaceutical stock management; however, this comes at the cost of increased nursing time. In general, the nurses remained supportive of the benefits for their patients, despite consequences to their workflows. Their acceptance of the ADC system in this study demonstrates this.
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Further reduction in MAE rate was observed to 0.05% following ADC implementation and appropriate product labelling with barcode systems.
“Further reduction in MAE rate was observed15 to 0.05 % following ADC implementation and appropriate product labelling with barcode systems.58”
From Benefits and challenges associated with implementation and ongoing use of automated dispensing cabinet for medicines: A scoping review (2025) · cites this paper as [58]
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Cited by
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Jung, Y. Y., Walsh, Á., Patel, J., & Lai, K. (2025) · Exploratory Research in Clinical and Social Pharmacy · doi:10.1016/j.rcsop.2025.100599 · Cited by 7 · see citing works
“58 It was highlighted that while there were reduced errors, changes in procedures and systems may incur a new set of risks.”
- Authors
- Wang, Y.-C., Tsan, C.-Y., & Chen, M.-C.
- Affiliations
- National Taiwan University Hospital (TW)
- Corresponding author
- Tsan, Chin-Yuan
- Venue
- JMIR Formative Research
- Publisher
- JMIR Publications Inc.
- Published
- 2021-09-17
- Volume
- 5
- Issue
- 9
- Pages
- e24542
- ISSN
- 2561-326X (ISSN-L)
- PMC
- PMC8486989
- OpenAlex
- W3193480594
- Cited by
- 17
- References
- 0
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 2 · 2022: 1
- FWCI
- 2.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Formative Research (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Health Professions › Occupational Therapy › Safe Handling of Antineoplastic Drugs
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Keywords
- automated dispensing cabinets, medication administration, medication administration errors, nursing workload, drug safety, nursing satisfaction, hospital pharmacy automation, adverse drug reactions
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