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The term “cross contamination” is used in the pharmacy trade to mean that somehow a second unintended drug has been issued or mixed with the primary (scripted) drug and, thereby has contaminated the primary drug.
This can happen in a wide variety of ways. Even the basic manual pill counting tray is prone to cross contaminating as all pills are poured onto a common surface to be counted. These trays should be cleaned frequently.
The pour-through counter suffers from the same problem; every pill hits in a common area and goes down a common chute, therefore every surface that comes in contact with pills should be cleaned often. Cleaning these units is a much greater chore than cleaning the pill counting tray as disassembly of parts is required.
When counting with a TORBAL Pill Counting Scales and pouring directly into a vial cross-contamination is completely eliminated, as tablets never come in contact with any parts of the unit. The robotic Cassette Systems with individual counting modules also appear to be free of cross contamination problems, as drugs can be placed directly into patient's vial.
Below is an example of cross contamination caused by uncoated generic brand tablets. The residue shown was left after a single pour of 1000 pills. Tablets were poured onto a black foam-board surface from the height of approximately 3 inches.
Pill Counting –the primary task in filling …? |
Most of us think of pill counting as the primary work in filling scripts in the modern pharmacy. That is probably not correct as the actual entry of the script into the Pharmacy management System (PMS) may well take more time to accomplish. Once the script is entered the PMS generates a label package that becomes the process driver unless the pharmacy has a full robotic machine on site. If the script calls for a drug that the Robot has in one of its drug cells, and the unit is capable of picking up a selected empty vial of the correct size (usually a choice of 2 or 3 sizes) and delivering it to a labeling station where the label is printed and applied, then the PMS will send the script info to the Robot. These robots are used for the top 100 to 200 drugs depending upon the script volume per day. The scripts that call for drugs in the balance of the formulary are sent forward to be filled manually (usually more than 50% of scripts representing 80%+ of the formulary).
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