Unitarization of medicines ou Unitarize (unit dose re-packaging in English) is the process of preparing the drugs in ready-to-administer form to the patient. This process in several hospitals is normally carried out in the Hospital Pharmacy, in the Medicine Storage Sector or Center Unitarization, but always under the responsibility and control of the Hospital Pharmacy.
Although an ampoule must be diluted in the Infirmary, to be considered a single dose process, we normally speak of unitarization and also when the Pharmacy converts it into units (blisters or ampoules) to deliver to the Infirmary, we call this process unitarization.
A unitarization involves two main processes: packaging and label printing or unit packaging.
This can be done manually or with machines. unitarizers.
Other tasks in the process unitarization are:
1) remove medicines from closed stock;
2) create a “request for unitarization” with the corresponding information: authorization, barcode, quantity of medicines, validity, etc.;
3) get the materials to unitarize;
4) cut the blisters;
5) separate medicines from their secondary packaging or boxes;
6) print the labels (in case of unitarization manual);
7) packaging and labeling: unitarize;
8) form appropriate groups for subsequent handling within stock and label;
9) store in a suitable place within the warehouse.
This process is normally carried out immediately upon receiving the medicines at the hospital and before entering the closed stock (stock 1). In processes of unitarization with automatic machines it is standard procedure.
In cases of unitarization Manually, it is not always possible to do this and sometimes, the medicines go into stock and later to be unitarized.
Today, there are machines that cut blisters automatically, which are used by hospitals with more than 200 beds or those wishing to purchase this equipment.
There are also semi-automatic machines for unitarization and devices to carry out the entire process in an automated manner, without the constant presence of the operator in all cycles.
Why Unitarize Medicines?
Mainly to centralize the control of medicines in the Hospital Pharmacy, differentiate packaging and add the bar-code from hospital.
Centralization of control allows for a reduction of up to 57% in Adverse events, according to two studies carried out in Germany and the USA.
There is also a reduction in the working time of the nursing team, to unitarize medicines on each floor and so reducing waste.
This process began to be disseminated around the world in 1965 and today it is the main global trend.
But its application is not yet widespread in all countries, including Europe, there are still several countries that send medicines to the wards in boxes that are unitarized at the time of use.
In the USA if unitarize or pack, many medications without blisters, received in large bottles, to be sent to the electronic cabinets in the wards or other sectors.
Unitarize to differentiate – Unitarization of Medicines
As ampoules and the blister packs received directly from laboratories do not have the necessary differentiation to be used within the hospital.
Each hospital and each professional Farmácia has its own rules about how to “customize” the presentation of the packing.
In general, incidents from the recent past influence the criteria adopted to ensure that new incidents do not occur. This creates a wide variety of differentiating criteria in each hospital, which the pharmaceutical industry cannot solve.
It is also important to place the Hospital's own barcodes. In some cases, a serial code is added to each package that has a different code or identification and can be tracked individually, from the beginning of the medicine's journey to its final destination with the use associated with a specific patient, so that every the process of unitarization have greater control.
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Taxis et al, Pharma World Sci. In Germany, they demonstrated a 53% reduction in AEs in favor of single doses
Barker, 1965. A study at a Hospital in Arkansas showed a 57% reduction in AEs when switching from the collective system to single doses.
