Table 1.

Setting characteristics before and after the implementation of central automated unit dose dispensing and barcode-assisted medication administration

Characteristics	Pre-intervention	Post-intervention
EMR systema	HiX®	HiX®
CPOE systema	HiX®, Practocol®	HiX®
Central ADDa	Not applicable	– Pillpick® in the central hospital pharmacy – Yes, for oral medication primarily – Automated processing of prescriptions in CPOE – Barcoded unit dose plastic bags (with medication name, strength, expiry date, lot number and national article identifier) attached to a plastic ring (supply for 12–24 h). General information of patient and attached medication (name, strength and administration time) are printed and attached to the ring. – Automated checking of expiry dates
Medication supply	– By the central hospital pharmacy – First order: ordered by pharmacy technicians when processing prescriptions in HiX® – Follow-up orders: by nursing staff electronically in HiX®. Telephone orders possible. – Multidose preparations such as inhalers: on request.	– Prescriptions automatically processed by the ADD software – Other medication: as pre-intervention
Medication stocking	Ward-based stock (tailored): emergency medication, commonly used medication and patient-specific medication (for several days)	As pre-intervention, but a smaller range of commonly used medication
Medication cart fillingb	By nurses, generally for 24 h	– By nurses, generally for 24 h—three wards – By pharmacy staff centrally for 24 h (weekdays) or 72 h (Friday)—three wards
BCMA
Patient identification by scanning	Possible, but not standard practice	Yes
Medication identification by scanning	No	Yes
BCMA features of medication identificationa	Not applicable	– Visual alerts in eMAR HiX® – Wrong medication, strength per unit, dosage form – No automated dose checking (e.g. number of tablets)
Workstations	On mobile medication carts with scanners	On mobile medication carts with scanners
Use of patient’s own medication or self-administration	Not standard practice, only under strict protocols	Not standard practice, only under strict protocols
Signing of administered medicationa	In eMAR HiX®: manually by nursing staff	In eMAR HiX®: manually or by scanning medication by nursing staff

^aHiX® version 6.1 (ChipSoft B.V.; Amsterdam, the Netherlands); Practocol® version 2.0.9.3 and 2.1.5.1 (Practocol B.V.; Rotterdam, the Netherlands) for medication in chemotherapy protocols (e.g. dexamethasone); Pillpick® (Swisslog; Buchs, Switzerland).

^bProcedures differed between wards because central filling was hampered by limited human resources.