ADVANCING SAFE MEDICATION PRACTICES WITH AUTOMATED DISPENSING CABINETS IN OPERATING ROOM AND ANESTHESIA SETTINGS: A SYSTEMATIC LITERATURE REVIEW
Author(s)
MONICA TELINOIU, MBA, MS1, Ari Varon, Student2, Craig Greszler, PharmD, MBA3, Shannon Johnson, PharmD, MBA3, Amanda Hays, PharmD, MHA3, Julia D. Lucaci, PharmD, MS4;
1Becton Dickinson, Franklin Lakes, NJ, USA, 2Tarbut V'Torah Community Day School, Irvine, CA, USA, 3Becton Dickinson, San Diego, CA, USA, 4Becton Dickinson, Vernon Hills, IL, USA
1Becton Dickinson, Franklin Lakes, NJ, USA, 2Tarbut V'Torah Community Day School, Irvine, CA, USA, 3Becton Dickinson, San Diego, CA, USA, 4Becton Dickinson, Vernon Hills, IL, USA
OBJECTIVES: Medication safety in operating rooms (ORs) and anesthesia settings (ASs) is challenged by high-acuity care, rapid decisions, and controlled substance access. This review evaluates the impact of automated dispensing cabinets (ADCs) on medication errors, workflow safeguards, and access.
METHODS: A systematic literature review was conducted in June 2025. Eligible studies reported empirical data on ADC use in ORs and/or ASs. Outcomes were grouped into three domains: (1) medication error-specific outcomes, (2) workflow-related safety risks, and (3) staff perceptions and access control.
RESULTS: Seven studies met inclusion criteria. From Domain 1 (errors), four out of five studies reported significant reductions in post-ADC implementation. In one study, ADCs lowered medication administration error rates from 11.9% with manual carts to 7.3% (p<0.01). A separate study reported a reduction of ADC dispensing incidents from 90 to 0, transport events from 2 to 0, and narcotics registry errors from 232 to 10. A near real-time synchronization process was also found to reduce controlled substance discrepancies from 16% to 5.2% (p<10⁻⁶). From Domain 2, six studies showed positive effects on workflow risks. For example, a quality improvement initiative led to a reduction in ADC overrides (17% to 4%) and order verification times [6.3 to 4.3 minutes (p=0.006)]. Another study demonstrated OR nurse time savings (32 minutes per shift) and reduced mid-case trips (64% to 13%), largely due to ADC placement inside ORs (referred to as "operating theatres” in this study). From Domain 3, five studies reported positive staff perceptions and tighter access control with one highlighting persistent compliance gaps (50% of discrepancies from 12% of providers), underscoring the need for training and oversight.
CONCLUSIONS: ADCs improve perioperative medication safety by reducing errors, overrides, and delays while enhancing inventory control and staff satisfaction. However, reconciliation discrepancies highlight the need for targeted training and complementary safeguards.
METHODS: A systematic literature review was conducted in June 2025. Eligible studies reported empirical data on ADC use in ORs and/or ASs. Outcomes were grouped into three domains: (1) medication error-specific outcomes, (2) workflow-related safety risks, and (3) staff perceptions and access control.
RESULTS: Seven studies met inclusion criteria. From Domain 1 (errors), four out of five studies reported significant reductions in post-ADC implementation. In one study, ADCs lowered medication administration error rates from 11.9% with manual carts to 7.3% (p<0.01). A separate study reported a reduction of ADC dispensing incidents from 90 to 0, transport events from 2 to 0, and narcotics registry errors from 232 to 10. A near real-time synchronization process was also found to reduce controlled substance discrepancies from 16% to 5.2% (p<10⁻⁶). From Domain 2, six studies showed positive effects on workflow risks. For example, a quality improvement initiative led to a reduction in ADC overrides (17% to 4%) and order verification times [6.3 to 4.3 minutes (p=0.006)]. Another study demonstrated OR nurse time savings (32 minutes per shift) and reduced mid-case trips (64% to 13%), largely due to ADC placement inside ORs (referred to as "operating theatres” in this study). From Domain 3, five studies reported positive staff perceptions and tighter access control with one highlighting persistent compliance gaps (50% of discrepancies from 12% of providers), underscoring the need for training and oversight.
CONCLUSIONS: ADCs improve perioperative medication safety by reducing errors, overrides, and delays while enhancing inventory control and staff satisfaction. However, reconciliation discrepancies highlight the need for targeted training and complementary safeguards.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
MT8
Topic
Medical Technologies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas