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Automated Dispensing Cabinets Improve the Governance of Controlled Drugs in Intensive Care Units

November 10th, 2022
Automated Dispensing Cabinets (ADCs)

Governing the access and use of controlled drugs in hospitals is essential for the safety of both patients and healthcare staff. Clinical areas such as Intensive Care Units (ICUs), with high use of controlled drugs, pose a significant challenge to the governance of these medications. While stricter control on the access and use of these drugs in the ICU improves safety, there are trade-offs.

Automated Dispensing Cabinets (ADCs) can play a vital role in overcoming these limitations and help make controlled drug governance in the ICU more effective and efficient.

Role of ADCs in Managing the Access of Controlled Drugs in ICUs

ADCs are not only more secure than traditional systems that might involve locked safes, but they also automate record keeping, saving time, and reducing errors. Studies have shown that implementing ADCs can also help identify controlled drug diversion by making monitoring and investigating instances easier.

ADCs Assist in Maintaining Access and Safety of Controlled Drugs

Automated dispensing cabinets have advanced security features that limit medication access to authorized personnel. The credentialed access and reporting system in ADCs makes it easy to track the flow of the controlled medication from the pharmacy to bedside. As an added layer of security, the ADCs can be configured to require authentication from more than one healthcare staff member before a medication can be withdrawn.

At the same time, controlled medications in the ICUs should be easily accessible during emergencies, and ADCs can do that. Systems can be configured with appropriate override options that save precious seconds during an emergency response in the ICU.

ADCs Improve the Ease of Documentation

Proper documentation is an integral part of controlled drug governance in the ICU. Traditional paper-based documentation is slow and error-prone. ADCs streamline the documentation of medications used in the ICU, to make the process more transparent and reduce the chance of errors.  

ADCs can be set to automatically record every transaction’s date, time, and staff member credentials, making manual entry of the data into the system unnecessary. Not only can this feature save time, but it can also eliminate discrepancies that result from human error. Further, the data entries in ADC systems are more legible and complete than in any manual, paper-based system.

Another advantage of using ADCs in the ICU is the ability to record the amount of medication remaining or discarded after the completion of a transaction. Although additional data entry is needed, the ADCs are much better at keeping track of multiple-use controlled medications than traditional systems.

Auditing inventory is also quick and efficient with ADCs in place. Inventory counts can be done remotely, which allows discrepancies to be addressed promptly. ADCs can also be programmed to alert the authorized user(s) if they make an error while calculating the remaining stock levels.

Several studies show that the satisfaction level of both nursing and pharmacy staff greatly increases after ADC implementation, in part due to this ease of documentation.

ADCs Make Monitoring Controlled Drugs Usage in the ICUs Easy

Monitoring the usage of controlled drugs in the ICU is crucial to prevent losses and diversion. While the traditional stocking methods allow for periodic audits, it is difficult to eliminate the bias of a manual recount.  ADCs allow ‘blind’ counts in which the nurses do not know the recorded balance on the system before counting the items in the drawer. The audits thus performed are more reliable. Stock audits with ADCs can be significantly faster than storage methods that use pen and paper documentation.

Another benefit of an ADC system is that it allows the pharmacy staff to generate reports remotely. The system can be set to send out alerts whenever a discrepancy is recorded.

ADCs Help with Reporting and Investigating Discrepancies

Any controlled drug discrepancy in the ICU can be easily identified through automatically generated daily stock reports. In contrast, with traditional dispensing systems, errors become evident only during an audits or unexpected stockout. Further, when an inconsistency is discovered, it is difficult and time-consuming to sift through all the records to find the origin.

With ADCs, discrepancies can be caught early and rectified to avoid potential stockouts. Additionally, as an ADC can generate a list of all those who accessed it, discrepancy investigations can be narrowed to just the relevant staff members.  


ADCs have great potential to alter the governance of controlled medications in ICUs. The benefits of ADCs in the ICU go beyond saving time, offering strictly controlled access to these substances. ADCs can improve workflow and streamline operations within an ICU, and allow nurses and pharmacy staff to collaborate in offering the best possible patient care.

The medDispense® series of automated dispensing cabinets from TouchPoint Medical are a highly customizable, secure, and versatile dispensing solutions that can be easily implemented in your ICU. They are flexible by design, cost-effective and built to be integrated into any existing workflow.  Please get in touch with us today to learn more about how we can help make your ICUs safer, more efficient and even increase staff satisfaction.