药品货位编码在武汉某新型冠状病毒肺炎定点收治医院的管理与应用

Management and Application of Drug Location Code in Wuhan Designated Hospital for COVID-19

目的:分析新型冠状病毒肺炎疫情期间新组建的医院药剂科采用药品货位编码进行药学保障服务的经验与不足,为突发公共卫生事件等紧急情况下新组建的医院开展药学服务提供借鉴。方法:武汉某新型冠状病毒肺炎定点收治医院采用四维立体编码法编制货位号编码,结合医院信息管理系统,用于药品的入库、出库和盘库。通过记忆字段假设法,比较药师在货位管理前后需记忆的字段数量;选择6名药师作为试验者,随机分为2组,在不同任务阶段(初期上岗第7天、中期第27天、后期第47天),观察与统计对照组(附无货位编码的出库单)和试验组(附有货位编码的拣货单)完成目标调配任务所需时间和调配差错率;比较该管理手段使用前后,20名药师完成药品盘库所需时间和盘库差错率。结果与结论:药品货位编码管理可提高药师的调配和盘库效率,降低调配差错风险。采用药品货位编码后,药师所需记忆字段由624个降至60个,盘库时间由3.17 h缩短至1.33 h,盘库差错率由7.98%降至1.83%。在不同任务阶段,试验组的调配时间均显著低于对照组(初期95.20 min vs.31.33 min,中期71.67 min vs.22.67 min,后期69.67 min vs.22.67 min),在任务初期经过货位编码管理的调配差错率显著降低(5.80%vs.1.45%)。同时,反思药品货位编码中的管理漏洞,如编制原则中"药品总数"设计不合理、高危、精麻、易混淆及近效期等特殊药品的编制原则缺失、机动码和应急预案的缺失,提出相应的解决策略,以期为突发公共卫生事件下药品的信息化管理提供借鉴。

Objective:To analyze the experience and insufficiency of using drug location code for pharmaceutical care in pharmacy department of a newly established hospital for COVID-19 and to provide references for pharmaceutical care of the newly established hospitals set up in emergency situations like public health emergencies.Methods:In one of Wuhan designated hospitals for COVID-19,four-dimensional encoding method was used for coding the location numbers.The method,combined with the hospital information management system,was used for the storage,outgoing and inventory of drugs.Through the method of memory field hypothesis,the numbers of fields that pharmacists need to remember before and after location management were compared.Six pharmacists were divided randomly into two groups,with the control group holding the warehouse out list without location coding and the experimental group holding the picking list with location coding.At different task stages(the 7 th day of initial work,the 27 th day in the middle of the work and the 47 th day of later work),the time of pharmacists to complete the target deployment task and the allocation error rate were observed and analyzed.The time needed by 20 pharmacists to complete the drug inventory and the inventory error rate were compared before and after the drug location coding management was used.Results and Conclusion:Drug location coding management could improve the efficiency of pharmacists’drug allocation and inventory and reduce the risk of allocation errors.After using drug location code,the numbers of memory fields needed by pharmacists decreased from 624 to 60,the inventory time reduced from 3.17 h to 1.33 h,and the inventory error rate decreased from 7.98%to 1.83%.At different task stages,the deployment time of the experimental group was significantly shorter than that of the control group(95.20 min vs.31.33 min in the early stage,71.67 min vs.22.67 min in the middle stage,69.67 min vs.22.67 min in the later stage),and the deployment error rate under the drug location coding management was significantly reduced at the beginning of the task(5.80%vs.1.45%).Meanwhile,we reflect on the drug location coding management and found many loopholes,such as the unreasonable design of"the total number of drugs"as far as the encoding principles are concerned,the lack of the encoding principles of special drugs of high-risk,fine anesthesia,easily confused and close-to-expiration ones,and the lack of mobile codes and emergency plans.Some corresponding solutions should be put forward so as to provide references for the information management of drugs in public health emergencies.