What Is a Medical Pass-Through Cabinet?
Medical pass-through cabinets are an all-encompassing term that includes any cabinet used in medical facilities where the cabinet is mounted into the wall and accessible from both sides of the wall. Nurse servers are a type of medical pass-through cabinet that stores medical supplies in patient rooms. A supply room staff member stocks the supplies from the hallway and a nurse can access those supplies from inside the patient’s room.
The intent of the nurse servers is to reduce the amount of time nurses spend retrieving necessary patient supplies from a central supply room and thus delaying care. With 90 percent of nurses saying they don’t have the time to properly care for patients, reducing unnecessary errands can make a difference, giving nurses back that precious time.
Nurse servers also decrease the risk for Hospital Acquired Infections (HAIs) being transferred by staff members entering patient rooms to stock the cabinets. The Centers for Disease Control and Prevention recently reported, “On any given day, about one in 31 hospital patients has at least one healthcare-associated infection.”
Increasingly more hospitals are realizing that installing nurse servers would enable nurses to be more efficient and deliver better patient care while also enabling hospitals to maintain strict isolation protocols.
Storing supplies at the room makes sense. Now, storing medications in the room is becoming a priority as well. The same benefits can be experienced by using specific medical pass-through cabinets to deliver patient medications to the patient’s room from the outside hallway. Medical pass-through cabinets used in this way enable pharmacy technicians to stock a patient’s cabinet:
- without entering the room, thus reducing the risk of transmitting infections
- with the exact medication in the prescribed dosage per patient to reduce the risk of medication errors
- so nurses don’t have to spend time walking back and forth to medication rooms and instead, dedicate that time to actual patient care
Reducing the risk for errors is an important factor as preventable medication errors affect more than 7 million patients and cost nearly $21 billion annually across all care settings. One of the culprits to these alarming statistics is a breakdown in pharmacy and nurse workflows.
An Accident Waiting to Happen?
In a common scenario, a nurse would visit a centralized medication room on his or her floor to access an automated dispensing cabinet. Bulk medications are stored in these cabinets in minimum quantities. The pharmacy must ensure minimum levels of many medications are available and not expired in the automated dispensing cabinet. Nurses walk back and forth from their patients’ rooms to the medication room to retrieve medications and dispense the dose of medications prescribed to their patients.
This set-up means nurses access the bulk-stocked automated dispensing cabinet multiple times a day and hopefully retrieve the right medications for their patients. Many automated dispensing cabinets include software for nurses to enter the medication they took and how many, but it’s still up to the nurses to input the correct medication name and the quantity dispensed. This process takes time: time for the nurses to go back and forth from the medication room to a patient’s room, back to the medication room and then to another patient’s room and so forth, dozens of times a shift. More time can be wasted as other nurses to wait in line until the nurse(s) in front of them get what they need from the cabinet.
Because the process is so inefficient and prevents nurses from being able to spend that time with patients, many nurses tend to cut corners. To save time, they may take several medications for multiple patients in one trip to the automated dispensing cabinet. This puts the patient at high risk for getting the wrong medications. Good intentions but bad outcomes.
Automated dispensing cabinets do have their place. They are most effective for securely storing emergency medications and high-profile medications in the patient care unit. In the event nurses cannot wait for the pharmacy to bring certain medications up to the floor, they can access the medications themselves via the automated dispensing cabinet.
Today, these cabinets often hold dozens of medications in bulk, many of which could be dangerous if misread, misdosed or given to the wrong patient. Keeping this many bulk medications in stock in automated dispensing cabinets throughout the hospital is also quite expensive and leads to waste.
The Benefits of Medical Pass-Through Cabinets
Medical pass-through cabinets for medications definitely enhances the nurse server functionality, however, the question of whether they can replace automated dispensing cabinets is a little more complex. There is definitely a case for automated dispensing cabinets, but having a medical pass-through cabinet in each patient room makes sense in so many ways.
Pharmacy still has automated dispensing cabinets in medication rooms, but they should be used for what they were designed to do: hold minimum quantities of emergency medications in bulk. They are not the best option for most prescribed medications. Medical pass-through cabinets, on the other hand, give pharmacies more control over medication management and ensure patients receive their prescribed medications, and no one else’s.
With medical pass-through cabinets, the pharmacy technician will bring up already-prepared medications in the exact amount the nurse is supposed to give a specific patient. The technician loads the pass-through cabinet at that patient’s room with only their medications in the prescribed quantity. Instead of the nurse having to go back and forth to a central medication room located somewhere on his or her floor, they only have to walk a few steps within the patient’s room and the medications are already there simply by opening the cabinet door. There’s no risk of them grabbing the wrong medication.
Software Maximizes Benefits of Medical Pass-Through Cabinets
The more modern medical pass-through cabinets take basic medical pass-through cabinets to the next level with digital access management. When a nurse needs to access the medical pass-through cabinet for supplies or medication, he or she swipes their proximity card and it unlocks the cabinet.
An Unexpected Benefit: Bridging The Gap between Pharmacy and Nursing
When medical pass-through cabinets came on the scene, some pharmacies were apprehensive. They believed the cabinets would reduce their control over the medication and require them to hire more people to stock the pass-through cabinets for each patient versus a few medication rooms. What they discovered, however, was quite the opposite.
They realized the cabinets reduced the amount of wasted medications. They also didn’t have to hire new people because the process of stocking the cabinets wasn’t as much work as they anticipated. Instead, they found by changing their process, they could plan their work better and become more responsive as a support department to nurses.
Instead of lots of surprises, rush orders, stock-outs and expired medications, medication management became more controlled and predictable. Nurses aren’t wasting medications, taking too much or the wrong medications. Nurses also know exactly where medications are and are confident it’s in the prescribed dosage.
Pharmacy technicians make their rounds with a transfer cart stocked with an entire nursing unit’s medications. They go from medical pass-through cabinet to another, stocking each patient’s medications in their own respective cabinet, then return to the pharmacy and restock. They typically only have to make one round per day and the number of one-off requests for medications dropped from dozens per day to nearly zero.
The medical pass-through cabinets bring more accountability and greater trust between pharmacy and nursing, while greatly reducing risk and cost. Nurses have the medications they need when they need it. Pharmacy knows who is getting each dose they dispense. There is more transparency and fewer assumptions.
The Difference between Medical Pass-Through Cabinets and Point-of-Use Cabinets
As hospitals become more proactive in reducing risk, they will inevitably need to decide how they will store medications and facilitate medication dispensing. They may have to determine which type of point-of-care cabinet is best for them: medical pass-through cabinet or point-of-use cabinet.
Related: Talon Upgrades Point-of-Use Medication Storage Cabinets to Enhance Accessibility and Reduce Cost
Medical pass-through cabinets go through a wall and have a door on either side of the wall. The nurse can be in the patient room and the pharmacy technician fills the cabinet from the hallway side. Point-of-use cabinets, on the other hand, can either be a recessed (flush-mounted) cabinet or mounted onto the wall’s surface inside of the patient’s room. The point-of-use cabinet still improves nurse efficiency by the nurse not having to walk back and forth to medication rooms. There are fewer medication errors because a pharmacy technician still stocks the cabinet with patient-specific medications, however, the technician must enter the patient room in order to stock the cabinet. This introduces the risk for infections.
Point-of-use cabinets use a similar access mechanism as a medical pass-through cabinet, where once the cabinet authenticates the user, it is unlocked and the nurse has access to individually-locked bins. This enables the hospital to designate certain bins for different purposes and employ different access authorizations if they desire.
The Benefits of Medical Pass-Through Cabinets Outweighs The Cost of Installation
One of the main sticking points for hospitals when it comes to medical pass-through cabinets is the cost of installing them in each patient room. Many hospitals are older and must be retrofitted for the cabinets. While it is ideal to install the cabinets during construction or a remodel, the benefits of any installation are greater than the cost.
The value of storing medications at point-of-care in medical cabinets extends beyond nurse efficiency. Reducing medication errors is a top priority for many hospitals. In fact, a Medication Error Prioritization System (MEPS) is a recent patient safety program that began as a study but showed such promise, has morphed into a comprehensive error prioritization system that hospitals are implementing to improve their overall patient care capacity.
Reputations and lives are at stake and most hospitals care deeply about both. Patients are vulnerable in a hospital and trust the hospital is doing everything in their power to provide the best quality care possible. Something as simple as a medical pass-through cabinet can improve patient outcomes as well as nurse and pharmacist satisfaction, leading to less turnover and better patient care.
Hospitals don’t have to choose one solution over another. The best vendors will offer a variety of options and consult with the hospital to choose a mix of products to meet every need. For instance, it’s a good idea to have automated dispensing cabinets for emergency uses and over-the-counter medications, such as acetaminophen. To maximize efficiencies and reduce risk, each patient room should have a medical pass-through cabinet for medications and a nurse server for supplies. Then, of course, there are all kinds of other medical cabinets and mobile carts to round out the mix. For hospitals aiming to consistently improve workflow efficiencies and patient care while reducing risk and costs, medical cabinets go a long way for a minimal investment.