Not applicable.
As reported by the Institute of Medicine, an estimated 106,000 deaths occurred in 1994 due to adverse drug reactions (ADRs), and more than 2,000,000 hospitalized patients experienced serious, if not fatal, ADRs. Lazarou J. et al., Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies, J. Am. Med. Assn. 1998: 279: 1200-1205. Many of these errors are attributable to the systems and methods used to store and deliver medications to those clinicians providing care to patients. Various solutions have been proposed to address the issue of medication delivery errors. For instance, computerized systems ensure that the medication ordered or prescribed by the clinician is clinically appropriate. These systems may verify that the dosage is proper based on patient information such as weight and evidence based guidelines or protocols. Also, these systems may perform interaction checking against other medications. However, even if the clinician orders an acceptable medication and dosage amount for a specific patient, the actual drug and/or dosage administered to the patient may vary from what was requested. A pharmacist or other clinician may accidentally provide an improper drug or drug dosage if the order is not properly communicated and followed at each step in the clinical process. For example, errors are encountered when a clinician has to perform the steps of (a) reading a request for a particular drug and drug dosage for a given patient, (b) retrieving the drug at the proper dosage while remaining cognizant of which patient is to receive the drug, and (c) placing the retrieved drug in an approved container or package so that it may be identified by the administering clinician. In addition to medication errors, existing systems and methods are wasteful and oftentimes difficult to use.
Improvements in delivery methods for unit-based doses of medications may be achieved through the automated dispenser of the present invention. In one aspect, the dispenser includes a frame and one or more cartridges adapted to be releasably mounted onto the frame. Each of the cartridges has slots extending through a body portion of the cartridge, with the slots sized for holding unit-based medications. The dispenser also includes a device positionable relative to the cartridges for inducing movement of selected unit-based medications from associated slots in the cartridge.
In embodiments, the frame may be supported by a base that enables rotation of the frame and thus cartridges releasably mounted with the frame. More specifically, a turntable motor may be coupled with the base, which provides a rotational output to align a specific cartridge with a device inducing medication movement from the cartridge. In this way, the turntable motor and device provide coordinated positioning of an effector that provides a force input into the associated cartridge slot for selected medication dispensing.
In another aspect, the dispenser includes one or more slotted cartridges adapted to be releasably mounted onto a frame, each cartridge having a plurality of slots arranged in a grid pattern. Also provided are a first device for inducing movement of selected medications from associated slots in the cartridges and a second device for aligning the first device with a particular cartridge. The first device is positioned to be at least partially surrounded by the frame, and includes at least one effector and a motor system supporting and positioning the at least one effector adjacent to an associated slot or group of slots in one cartridge that holds a selected unit-based medication to be dispensed. The motor system positions the at least one effector along at least one coordinate system axis (e.g., a vertical y-axis) in association with the second device rotationally aligning the cartridge holding the selected unit-based medication with the effector. A turntable motor forms the second device, which rotates the frame and cartridges relative to the effector of the first device.
A method of automated dispensing of unit-based medications is provided in another aspect of the invention. An input is received regarding a particular unit-based medication to be dispensed. A container having a plurality of slots extending therethrough is aligned with an effector in response to the input. Such alignment positions the effector relative to a slot of the container holding the unit-based medication to be dispensed. The effector then imparts a force on the particular unit-based medication located within the associated slot to move the dose from the container so that it may be retrieved. Each unit-based medication may be individually packaged with an associated identification marking so that it may be verified before the medication is administered to a patient.
The automated dispenser eliminates the errors associated with communicating orders to the clinician administering the medication. It also reduces the human interactions required to handle the medications. Not only are efficiencies gained by automating this process, but the tendency for human error in the medication delivery process is reduced as well. Additional advantages and features of the invention will be set forth in part in a description which follows, and in part will become apparent to those skilled in the art upon examination of the following, or may be learned by practice of the invention.
In the accompanying drawings, which form a part of the specification and are to be read in conjunction therewith and in which like reference numerals are employed to indicate like parts in the various views:
An automated unit-based medication dispenser 100 in accordance with one embodiment of the present invention is shown generally in
The enclosure 102 provides a controlled environment in which the medications are housed. In an embodiment, a refrigeration unit 121 may be coupled with the enclosure 102 to control the temperature and humidity level within the enclosure, which is desirable to avoid spoilage of certain types of medications. Additionally, the enclosure 102 regulates access to the medications, such that only those medications that have been dispensed from the cartridges 106 may be removed from the enclosure 102. The medication ordering information may therefore be used to account for the actual quantity and types of unit-based medications that have been made available for retrieval from the dispenser 100. This facilitates auditing of access activities, as well as providing a record for proper capturing a charge to facilitate payment for the medication.
Turning in particular to
In an embodiment, the slots 124 of the panel sections 114 and the slots 110 of the cartridges 106 have a matching configuration, as shown in detail in
The cartridge slots 110 may be preloaded with designated unit-based medications 128 suitable for automatic dispensing. An adhesive barrier sheet (not illustrated) may be secured to each respective surface 130, 142 of cartridge 106 to maintain the medications 128 in the respective slots 110 between the time the cartridge 106 is preloaded with medications and when it is removably mounted onto the one of the panel sections 114 for dispensing activity. The rear surface 142 also has a set of attachment prongs 144 and a boss 146, as shown in
Each unit-based medication 128 may be placed in an individual package 154 with an identification marking, such as a bar code 156, formed onto the package 154, as shown in
As previously described, the turntable motor 136 drives rotation of the base 134. This movement serves to rotationally align the effector 126 with a specific panel section 114 upon which is mounted the corresponding cartridge 106 housing the preselected unit-based medications 128. The turntable motor 136 is mounted onto a platform 158 and has a housing 160 that supports the frame 104 and the device 112 inducing medication movement from the cartridge. More specifically, a base 162 of the device 112 has a lower portion 164 extending through an opening 166 in the base 134 of the frame 104 and mounted directly onto the turntable motor housing 160. An annular bearing set 168 supports the base 134 of the frame 104 in rotation on top of the turntable motor housing 160. The output of the turntable motor 136 includes a gear 170 rotating on an axis parallel with the plane of the frame base 134. The gear 170 engages with an annular track 172 formed on a bottom surface 174 of the base 134 to drive rotation of the frame 104 relative to the turntable motor housing 160 and thus the position of the panel sections 114 relative to the effector 126.
In an alternative embodiment, the rotating output of the turntable motor 136 may extend upwardly to connect with the base 162 of the device 112 inducing medication movement, and the frame base 134 may be rigidly affixed onto the turntable motor housing 160. Thus, the device 112 would be rotatable with respect to the stationary frame 104 in providing general rotational alignment between a designated panel section 114 and the effector 126.
The specific features of the device 112 inducing movement of unit-based medications from the dispenser 100 are best illustrated in
A first support 178 of the x-y motor system 176 has a front end 180 presenting a channel-forming member 182 that receives a free end 184 of the effector 126 therein. The first support 178 also has a back end 186 to which a body portion 188 of the effector 126 is mounted. A horizontal linear movement component 190 of the x-y motor system 176 includes a first servo motor 192 having an output coupled with a lead screw 194 rotatable within a sleeve 196 to drive linear motion of the first support 178 and the effector 126. The first support back end 186 has a block follower 198 that slidably mounts onto the sleeve 196 and engages with the lead screw 194 so that turning of the lead screw by the first servo motor 192 moves the effector 126 along the horizontal x-axis to the specific column in which the designated slot 124 is located. The first servo motor 192 output reaches the lead screw 194 through a drive belt 200. A second support 202 provides a rigid structure upon which the first servo motor 192 and the sleeve 196 are mounted, thereby supporting the first support 178 and effector 126. A vertical linear movement component 204 of the x-y motor system 176 includes a second servo motor 206 having an output coupled with a lead screw 208 rotatable within a sleeve 210 to drive linear motion of the second support 202. The second support 202 has a back side 212 upon which a block follower 214 is mounted. The block follower 214 is slidably mounted onto the sleeve 210 and engages with the lead screw 208 so that turning of the lead screw 208 by the second servo motor 206 moves the second support 202 along the vertical y-axis, thereby positioning the effector 126 at the specific row position for the designated slot 124. The second servo motor 206 output reaches the lead screw 208 through a drive belt 216. A support tower 218 extending upwardly from the base 162 of the device 112 provides a rigid structure upon which the second servo motor 206 and the sleeve 210 are mounted, thereby supporting the second support 202, the horizontal linear movement component 190, the first support 178 and the effector 126. Therefore, the components of the x-y motor system 176 align the effector 126 with the specific row and column position for the panel section slot 124 that corresponds with the cartridge slot 110 holding the preselected unit-based medication 128 to be dispensed.
The effector 126, in one embodiment, is a pressurized air director formed with an internal conduit connected with a pressurized air supply (e.g., an air compressor). The effector free end 184, therefore, directs a flow of air towards a designated panel section slot 124 to reach the preselected unit-based medication 128 disposed in the associated cartridge slot 110, as seen in
It can be understood by those of skill in the art that the effector 126 may produce a different type of force incident upon the unit-based medication 128 in one of the cartridge slots 110 to effect dispending. For instance, the effector 126 may be formed as a pneumatic or hydraulic cylinder with the free end 184 serving as a movable piston extendable into the cartridge slot 110 to push the preselected unit-based medication 128 out of the cartridge 106.
To direct the movement activities of the device 112 and turntable motor 136, electronic controls may be coupled with the x-y motor system 176 and the turntable motor 136. The electronic controls, in one embodiment, include circuitry, such as a microprocessor, microcontroller or application-specific integrated circuit, along with associated memory storing embedded software, for handling the receiving of input signals and generating, in response command signals directing the activity of the x-y motor system 176 and the turntable motor 136. For instance, the input signals may be associated with the particular unit-based medication 128 requested to be dispensed. More specifically, the input signals may identify a particular unit-based medication 128 requested, and the electronic controls may lookup in a database the particular cartridge slot 110 location (associated with a specific slot 124 of one of the panel sections 114) that is associated with the medication 128. Alternatively, the input signals may already be formatted to designate the particular cartridge slot 110 location. In either case, the electronic controls generate command signals based on the input signals that cause (a) the turntable motor 136 to rotate the frame base 134 and thereby generally align the particular panel section 114 to which is mounted the specified cartridge 106 housing the preselected unit-based medication 128 with the effector 126, and (b) the x-y motor system 176 to position the effector 126 at the proper row and column position of the panel section slots 124 to effect movement of the preselected unit-based medication 128 from the associated cartridge slot 110.
Another embodiment of an automated unit-based medication dispenser 300 is depicted in
With reference to
The frame 104 of the dispenser 100 may also be adapted so that the panel sections 114 are not needed for removably mounting the cartridges 106 with the frame 104. In an embodiment depicted in
To mount one cartridge 106 with the frame 104, the cartridge is moved horizontally towards the frame 104 and to a position between adjacent rails 220 so that the lateral ends 234 of the cartridge 106 are immediately adjacent to aligned faces 222a of the rails 220 and the locking pins 228 of the aligned faces 222a are vertically aligned with the elongate grooves 230 of the cartridge 106. Continued horizontal movement causes the locking pins 228 to slide into the elongate grooves 230 and extend into the recesses 232 by the force of the compressed spring 226. At this point, a rounded end 238 of each locking pin 228 engages with the recess 232 to maintain the position of the cartridge 106 in place on the rails 220, as seen in
A pair of anti-rocking ribs 240 are formed onto the lateral ends 234 of the cartridges 106. Each rib 240 extends vertically along one of the lateral ends 234 at a position forwardly of the recess 232. When the cartridge 106 is mounted onto the rails 220, the ribs 240 contact a second set of faces 222b of the rails 220. In this way, the ribs 240 prevent rotation of the cartridge 106 about an axis aligned with the bores 224 of the aligned faces 222a to which the cartridge 106 is mounted.
As can be appreciated, the frame configuration depicted in
Therefore, the various embodiments of the unit-based medication dispenser of the present invention enable desired unit-doses of particular drugs/medications to be selected and dispensed by an automated process, reducing the potential for human error. Furthermore, each dispensing event may be registered by the electronics orchestrating the movement device activity, or by a person removing prepackaged unit-based medications from the dispenser and scanning the bar code or other identification markings on the packaging. Since certain changes may be made in the above invention without departing from the scope hereof, it is intended that all matter contained in the above description or shown in the accompanying drawing be interpreted as illustrative and not in a limiting sense. It is also to be understood that the following claims are to cover certain generic and specific features described herein.
This application claims priority to commonly owned U.S. provisional application Ser. No. 60/772,382, filed Feb. 10, 2006, incorporated by reference in its entirety.
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