Discussion about temperature-sensitive medications typically centers around maintaining specific temperature ranges through the supply chain, from point of manufacture to a hospital or facility. Yet once these medications reach a healthcare facility, they often must be stored within that same temperature range until they’re administered to the patient.
Call it the “last mile,” but at the University of North Carolina Health Care system it may refer to the last few feet to the patient. UNC Health Care is a not-for-profit integrated healthcare system owned by the state of North Carolina and based in Chapel Hill. Established in 1998, the system includes the UNC School of Medicine Medical Center and nineaffiliate hospitals/hospital systems across the state. In all, the system provides 3,400 beds for patient care.
Since 2015, several of these UNC Health Care facilities have employed medical-grade Evolve™-brand refrigerators from Phononic to keep patient medications in the 2°C to 8°C range.
Phononic says the Evolve medical-grade refrigerators meet CDC guidelines for controlled storage of vaccines and pharmaceutical drugs. Evolve units use proprietary solid-state technology and feature precise temperature control designed to meet NEC requirements. Temperature is controlled to a less-than-one-degree variability, all while operating at a quiet level of less than 35 decibels at close proximity. That means the units provide uniform, precise and reliable cooling without the noise, toxicity and other detriments of conventional vapor compression refrigerators.
The units use cleanroom-compatible solid-state heat pump technology coupled with a non-hazardous, non-toxic refrigerant. Evolve refrigerators integrate a temperature monitoring system with NIST-certified glycol and air sensors. The doors feature keyless entry with a password-protected lock. The Evolve refrigerators allow users to log in locally or via WiFi-enabled remote storage.
Benefits for UNC Health Care system
Chad Hatfield, Assistant Director of Pharmacy at the UNC Medical Center in Chapel Hill, estimates that there are more than 100 Evolve units in use within the UNC Health Care system. These are located on or under hospital pharmacy counters, in climate-controlled medication rooms, at nursing stations or in individual patient rooms.
“The refrigerators may contain any medications that require refrigeration, such as vaccines used to prevent pneumococcal disease [infections caused by Streptococcus pneumoniae bacteria], insulin, and antibiotics,” explains Hatfield. “We tend to keep medications used frequently in the Evolve refrigerators so they’re quickly accessible to treat patients.”
UNC Health Care does use refrigerators from other suppliers but Hatfield points out the following three key benefits that give the Phononic Evolve units the advantage:
• Most refrigerators give off heat—Evolve does not.
• Many refrigerators have internal components that occupy a certain amount of square feet that reduces the amount of actual space available for medications. Evolve uses a low-profile, solid-state refrigeration system, allowing UNC to maximize the space inside the refrigerator to store meds.
• To more efficiently meet regulatory compliance issues, UNC plans to convert its recordkeeping system to a cloud-based system to monitor and track medication temperatures.
Says Hatfield, “The Evolve system is cloud-based, and it will allow us to better maintain and track any potential temperature spikes for medications. These could come from the refrigerator being opened frequently within a short time span, or if a refrigerator goes out. For example, if a refrigerator goes out on a Friday night and isn’t recognized until Monday morning, we would have to figure out if meds were out of a temperature range, and if so, for how long.”
Only accredited nursing staff members and/or pharmacists are allowed access to the locked Evolve units. In use, a facility would order certain meds via the UNC Health Care system computer network that would be filled by a pharmacist or nurse who would open the refrigerator, remove the needed medication and place it into position on a medication management system, such as the Pyxis MedStation™ from CareFusion.
New facility opens with Evolve units
UNC REX Healthcare recently opened a Heart & Vascular Hospital, outfitting it with a combination of 1.8 and 5.5 cu-ft Evolve products in its pharmacy, patient support areas and medicine rooms in conjunction with medication management systems. The installation was facilitated by REX Health Ventures (RHV), a platform created by UNC REX Healthcare “to foster and nurture innovative technologies and companies in the healthcare sector.”
The Evolve units aim to change how UNC REX Healthcare delivers patient care, equipping staff with more accurate, reliable temperature control and inventory protection. As nursing staff no longer needs to be concerned about refrigerators, it enables them to spend more time with patients and their families providing better and more comprehensive care.
“The Evolve refrigerators are simplistic in design and have less moving parts, which makes them easy to maintain and energy efficient,” says Jeff Carter, Director of Facilities, Construction and Biomedical Engineering at UNC REX Healthcare. “When we tested the refrigerators in the lab, we found them to be very reliable, providing close, tight temperature tolerances and were easy for staff to access and use. This is why we decided to deploy Evolve in our new 306,000-square-foot hospital.”