When it comes to drug refrigeration systems, either in the pharmacy or on the floors, the goal is to have systems that work dependably in the background, maintaining drugs within their required temperature ranges, without causing any hassle for pharmacy staff. When refrigeration systems go out of range, not only are there safety and product loss risks, but there is also a drain on pharmacy resources. Being pulled away from more important tasks to address an out-of-range system invariably leaves pharmacists frustrated.

Given these challenges, switching to medical grade refrigerators for medication storage can make a positive impact in several ways. Medical grade refrigerators ensure temperature consistency, provide ease of serviceability, integrate with wireless temperature monitoring systems, and are able to bring temperatures down much more quickly than non-medical grade units. For drugs with very narrow allowable temperature ranges, such as vaccines, the ability to consistently keep the temperature within range is key. Because of the greater efficiency of compressors in medical grade refrigerators, they reach their target temperature faster and are able to maintain it better. While non-medical grade refrigerators can take 15-20 minutes to bring the temperature back down to the target range after the door is opened, medical grade refrigerators generally stay within range even when the door is opened.

Features Checklist
When looking for the right medical grade refrigerator, you should consider serviceability, storage volume, and ability to maintain consistent temperature. A front-mounted compressor will allow for easier service than a compressor that is behind the cabinet. When determining the cubic volume you require, consider your current, as well as future storage needs. If possible, demo a unit by checking how quickly it is able to bring the temperature back down to the established range after the door is opened repeatedly. 

It also is important to consider the construction material. Stainless steel refrigerators are highly durable, unlike non-medical grade refrigerators that are typically constructed with plastic and other less sophisticated components. Cheap or flimsy hinges and seals will result in temperature leaks and an overburdened compressor, so it can be valuable to review the products with your engineering department who can address issues such as compressor life and cost and ease of serviceability. Another situation-specific option is to include glass front doors, which allow you to visually inspect product without opening the door; fewer openings will positively impact the life of the unit.

Digital thermometers mounted on the front of the refrigerator also are ideal as they allow for easy monitoring without having to open the refrigerator door. In addition, the ability to easily mount electronic locking mechanisms that tie in with automated dispensing cabinets (ADCs) is another advantage to medical-grade refrigerators. Many vendors now offer a specific flange on the door built to accommodate an electronic lock that can be manipulated by an ADC or pharmacy information system.

Temperature Monitoring
As I am sure others have noticed, after transitioning to automated temperature tracking, but prior to purchasing medical grade refrigerators, we realized the amount of temperature adjusting we needed to do every day was significant. That discovery really clarified the need to replace our refrigerators.

Typically one of the first things a TJC surveyor looks for is documentation establishing consistent monitoring of refrigerators. With an automated temperature monitoring system, reports are easily acquired to demonstrate consistency. When using a Web-based, wireless temperature monitoring system, there is never a time when refrigerator performance cannot be assessed, even in clinics that are closed over the weekend.

Return on Investment
While medical grade refrigerators usually require a higher upfront investment than their non-medical counterparts, the expenses resulting from lost product in the event of a failed refrigerator can easily run into the thousands of dollars. There is additional risk for facilities involved in the national Vaccines for Children program or similar state programs. Needing to replace a significant amount of product, especially those given to the hospital for free, initiates a direct cost to taxpayers and could put your enrollment in such programs in jeopardy.

The substantially higher quality of medical grade refrigerators can help secure a long-term investment in the safe and proper storage of medications. Depending on the size of your facility, such an upgrade can involve the acquisition of a large number of units. This can be used as a negotiation point with vendors, as some may offer discounts for volume. 

Conclusion
The use of medical grade refrigerators instills confidence that refrigerated medications are properly maintained. With medical grade refrigerators and wireless temperature monitoring, refrigeration issues—which used to take up a lot of time—can recede properly into the background.


Peter Haverkamp, RPh, is director of pharmacy services at Metro Health Hospital in Wyoming, Michigan, and serves as an adjunct faculty member in the College of Pharmacy at Ferris State University. Peter has written and presented both nationally and internationally on medication safety issues.

Special PP&P Buyer’s Guide: Medical Grade Refrigerators

For your convenience, Pharmacy Purchasing & Products has compiled the following buyer’s guide for medical grade refrigerators and related products. This is just a sampling of the products available to improve your pharmaceutical refrigeration needs.

NuAire, Inc
www.nuaire.com
The Glacier -86°C Ultra Low Temperature Freezer line comes in three sizes: 11.8, 17.1, and 23.6 cu ft. Each unit features HFC (CFC-free) refrigerants, polyurethane foamed-in-place insulation, low-noise operation, audible and visual alarm systems, an internal chamber pressure release gasket, and an eye-level control center. With heated door seals, each unit has two air insulated inner doors covering a total of four compartments with three adjustable shelves. Sitting on heavy-duty swivel casters, the freezers have a microprocessor control system that handles the air-cooled cascade refrigeration system, down feed evaporator, and high-capacity air-cooled condenser.

Talyst, Inc
www.talyst.com
The AutoCool pharmacy refrigerator from Talyst provides access-controlled refrigerated storage and automated dispensing for valuable refrigerated medications. AutoCool is flexible, scalable, and can be installed in remote locations. The secure unit supports bar code confirmation of all stocking, picking, and dispensing and enables perpetual inventory management with par levels and order preparation. Multiple AutoCool units can be daisy-chained to automate all or just a portion of refrigerated items. AutoCool works in conjunction with Talyst’s pharmacy automation storage units and software.

Veracity Group Inc
www.veracitygroupinc.com
The patent-pending VersaFridge modular design includes a “hot swappable” refrigeration module allowing for all maintenance to be performed without having to remove the contents, or the refrigerator from its location. Other design benefits include fully welded, stainless steel construction, a 1.6 max amp draw that uses less than 1.3 KWH per day, 5.68 cu ft of usable space, a digital controller (°F/°C) with alarming, and a self-closing door.

The VersaFridge allows for the mixing and matching of shelves and drawers, swapping between refrigerator and freezer functions by changing the module, and integrating connections for the VersaTrak wireless temperature monitoring system. VersaFridge has multiple ergonomic locking options and offers a lifetime cabinet warranty and five-year total refrigeration module warranty.

Follett Corporation
www.follettice.com

Under Counter Refrigerators
Follett’s medical-grade under counter refrigerators feature microprocessor controllers, powerful compressors and forced air-cooling to deliver rapid pull down, consistent temperatures throughout the cabinet, and immediate recovery after door openings. An external digital display shows temperature in Fahrenheit or Celsius for easy logging and operation confirmation. Completely front-breathing, these refrigerators can be installed below counters, as no-top, side, or back ventilation is required and they are compatible with all major automated medication dispensing systems. Full stainless interiors, exteriors, and internal frames resist corrosion and provide durability. Doors are equipped with cylinder locks for medication security. Edge-mount hinges stand up to heavy use and are field reversible for installation flexibility.

Full-size Refrigerators
Follett’s upright refrigerators offer advanced features for cabinet-wide cooling, user-programmable monitoring and alarming, and energy savings. The back airflow design delivers cold air to six levels, ensuring top-to-bottom temperature consistency. Follett’s feature-rich interface includes a large, three-inch LCD temperature display with intuitive navigation to all settings. Audible and visual alarms include high/low temperature, power failure, door-ajar, low battery, and probe errors. Dry contacts and an RS-485 port allow remote alarming and data streaming. Energy saving features include full-length LED light bars that generate virtually no heat, 2.75 inches of insulation to reduce power consumption, and dual-pane glass doors with low-E coating. Stainless steel interior and exterior is standard. Six models with 20 or 24 cu ft capacities are available with shelves, baskets or drawers.

Health Care Logistics, Inc
www.healthcarelogistics.com
Health Care Logistics offers products for use in pharmacy
refrigerators to properly store and manage pharmaceuticals.

Internal Refrigerator Locking Boxes
Deluxe refrigerator locking boxes keep supplies secure and enable users to restrict access to temperature-sensitive drugs while keeping them stored at a regulated temperature. Made of clear, durable plastic, these front-opening boxes allow for easy visual inspection of contents and a roll-stop lip prevents vials from rolling over the edge of the box. The box can mount to the underside of a wire shelf above it, and the thin, flat attachment mount takes virtually no space away from the shelf above. Heavy-duty, double-sided tape secures boxes to glass shelves. Available in two styles—easy mount and compact easy mount—with a keyless digital lock, a key lock, or a double key lock. Accessories include removable trays, dividers, and a series of covers.

Miniature Fridge
The Petite Fridge is a small, portable refrigerator that offers a convenient and affordable way to keep medicines at a safe temperature. Offering a locking option to keep contents protected and secure, the Petite Fridge uses thermoelectric cooling, offering an alternative to large refrigeration units that require a compressor for operation. Each unit operates on 12V DC power and is supplied with a 100-240V AC adapter. Wall-mountable, it extends only four inches from the wall and complies with ADA standards. The Petite Fridge features two cubic liters of storage space with key lock, digital lock, and non-locking models available.

SANYO North America Corp
us.sanyo.com/biomedical
The SANYO MDF-Series -86°C ultra-low freezers feature SANYO Cool Safe refrigeration systems designed to deliver energy-saving, high-performance cooling. Designed for long-term preservation of biologicals, the VIP Series offers the maximum storage volume in the smallest possible footprint. SANYO Cool Safe Compressors are specific to ultra-low applications, and they reduce compressor temperatures internally and externally, which increases compressor longevity, reliability, and reduces heat output to the room. In addition, the VIP vacuum panel composite insulation combines high-efficiency vacuum-panels with conventional polyurethane structural foam and barrier film offering an increased interior volume while maintaining conventional dimensions, thereby offering more storage capacity per square foot of occupied floor space.

Nor-Lake, Inc
www.norlake.com
Nor-Lake Scientific pass-thru refrigerators are available in one of three configurations—with a glass front door and solid back door, with two glass doors or with two solid doors. All models feature microprocessor control with high/low audible and visual alarm, remote alarm contacts, and an LED digital display. The exterior front, solid doors, and sides are white. The interior liner and interior door panel are white and there are three epoxy-coated shelves per door, which can be adjusted in one inch increments and are available with several optional features including two-way sliding basket drawers and/or stainless steel drawers.

Helmer, Inc
www.helmerinc.com
Helmer’s pharmacy refrigerators provide a secure environment for valuable pharmaceutical products. Designed and manufactured specifically for life science and vaccine storage applications, the units feature bacteria-resistant powder coating, foamed-in-place urethane insulation, and uniform temperature.

Pass-thru Refrigerators
Helmer’s Pharmacy Pass-Thru refrigerators feature superior temperature uniformity with quick recovery and self-closing doors with magnetic gaskets to ensure proper closure. A covered top on the cleanroom side prevents accumulation of dust particles and reduced humidity levels in the pharmacy models offer a drier storage environment. Custom storage options include drawers, rollout baskets, and shelves. A skirt designed for the bottom of the cleanroom side conceals the space between the refrigerator and floor. Pass-thru refrigerators are available in both i.Series and Horizon Series lines and in 25 and 56 cu ft capacities.

Under Counter Refrigerators and Freezers
The Horizon Series and i.Series under counter refrigerators and freezers can be placed under the counter, used free-standing, or stacked. Featuring superior temperature uniformity with quick recovery and a bacteria-resistant powder coating, the i.Series models include the i.C3 temperature monitoring system and Horizon Series models include a door mounted alarm/monitoring system. The under counter refrigerators and freezers’ Sure-Seal door design features self-closing doors with magnetic closure, field reversibility, and a key lock. The unit has an interior volume of 5 cu ft with a standard configuration of two shelves. Options include an interior light, swivel casters, rollout baskets, stainless steel interior/exterior, and a glass door.

Marvel Scientific
www.marvelscientific.com
Under Counter Refrigerator
The 6CARM features the MicroSentry Scientific refrigeration monitor and one-touch digital controls to provide superior temperature accuracy and monitoring. It is front vented, eliminating the need for clearance in built-in applications, and fits easily under benches and casework. The 6CARM is available with a solid or glass door. The solid door comes with a lock and a probe port and the interior has two adjustable shelves with three shelves in the door. With an interior volume of 6.1 cu ft and exterior dimensions of 34x24x24 inches, the 6CARM has a temperature range of 1°C to 7°C and runs an auto cycle defrost.

Modular Refrigerator and Freezer Combination
The Modular Series features 10.6 cu ft of total interior volume (6.1 cu ft in the refrigerator, 4.5 cu ft in the freezer) in a combination refrigerator/freezer that requires less than 4 sq ft of floor space. Offering a -20°C freezer in combination with a refrigerator, the units have separate thermostats and mechanical systems for each section. The refrigerator has MicroSentry Scientific control and the freezer has a knob temperature control with digital display. Marvel Scientific refrigeration systems can be customized to your specifications and the Modular Series is available in flammable material storage and hazardous location configurations, and uses non-CFC refrigerant.

Continental Refrigerator
www.continentalrefrigerator.com
 Products from Continental Refrigerator are environmentally safe and use CFC-free refrigerants in both refrigerators and freezers. Prior to shipping, all Continental Refrigerator units must pass a series of tests including bar coded computer refrigerant charging and vacuum leak decay checks, helium leak detection, vibration noise level, visual examination, and a temperature analysis recording, which is supplied in each cabinet’s manual packet.

Glass Door Refrigerators
Continental offers its two-section, glass door refrigerator in both a solid back and pass-through configuration. Both models feature an adjustable temperature control range of 2°C to 8°C with a factory preset of 4°C, stainless steel case front and aluminum end panels and interior, use of environmentally safe R-134a refrigerant, three inches of non-CFC polyurethane foam insulation, cam-action lift-off hinges, and self-closing doors. In addition, the doors have magnetic, snap-in gaskets and cylinder locks for security. The units operate with an automatic condensate evaporator, an external digital thermometer, and fluorescent interior lighting.

Solid Door Freezer
Featuring many of the same structural elements as the refrigerator line, Continental’s solid door freezer has an adjustable temperature control range of -22°C to -12°C with a factory preset temperature of -20°C, automatic electric defrost, and uses environmentally safe R-404A refrigerant. As with the refrigerators, the freezers stand on heavy-duty five-inch castors and employ epoxy-coated steel shelves.