Unitarizing (Unit dose repackaging) is the process of preparing the drugs in ready-to-administer form to the patient. That is, without any necessary preparation to be performed in a subsequent operation. This process is normally performed in the Hospital Pharmacy, Drug Store Sector or Unitarization Center for several hospitals, but always under the responsibility and control of the Hospital Pharmacy.
Although an ampoule that should be diluted in nursery, is not strictly a unit dose, by extension of unitarization speech when converted into dosage units for a patient.
Unitization involves two main processes: packaging and printing of the label or unit packaging.
This can be done manually or with machines.
Other tasks of the unitarization process are: 1) to take off the medicines from stock, 2) to assemble a unitarization order with the corresponding information: authorization, barcode, quantity of medicines, validity, etc. 3) to get materials to unitarize 4) to cut the blister 5) separate the drugs from their secondary packages or boxes 6) to print the labels (in case of manual unitization) 7) to pack and label 8) to form suitable groups for the subsequent handling of the stock 8) to place again in the warehouse .
This process is performed immediately upon receiving the drugs at the hospital and before entering the main stock (stock 1) in almost all cases of unitarization with automatic machines. In cases of manual unitarization it is not always possible to do so.
Nowadays there are also machines that cut blisters automatically and that are used by hospitals with more than 200 beds.
There are also semiautomatic machines for unitarization, devices to perform the whole process in an automated way, without the constant presence, in all the cycles, of the operator.
Information can be found on the website: www.opuspac.com
Why to unitarize? Mainly to centralize the control of the medicines in the Hospital Pharmacy and to differentiate the packages. Also, to place a hospital bar code.
The centralization of control allows a reduction of up to 57% in Adverse Events, according to two studies conducted in Germany and the USA.
There is also a decrease in the time taken by nurses to unitarize on floors and less waste.
This process began to spread in the world from 1965 and today is the main world trend of change.
But its application is still not widespread in all countries, as in Europe, several countries still dispense drugs to the infirmaries in boxes that are then unitarized at the time.
In the US, many drugs are unitarized without blister, received in large bottles, to then be sent to the electronic dispensers of the infirmaries or sectors.
Unitarize to Differentiate
Blisters and ampoules received from laboratories do not have the necessary differentiation to be used inside the hospital.
Each hospital and Pharmacy professional has its own rules on how to “customize” the packaging presentation. In general, recent past incidents influence the criteria to protect against new incidents. Its creates a wide variety of differentiation criteria in each hospital, which the laboratory industry cannot solve.
The placement of hospital bar codes and even serial code, that is, each package has a different code and can be tracked individually from the beginning to the end of its use and linked to a patient, makes the whole process of Unitarization has more practical sense.
Taxis et al, Pharma World Sci. In Germany, they demonstrated a 53% reduction of AD in favor of the single dose
Barker, 1965. A study in an Arkansas Hospital gave a 57% reduction of AD, when it passed from the collective system to the unit dose.