自動化智能藥櫃於我院應用概況與體會

Application and review on the use of automated dispensing cabinets in our hospital

目的改變病區藥物管理模式,提高護士執行醫囑效率,促進患者及時、合理用藥。方法使用自動化智能藥櫃(automated dispensing cabinets,ADC)對本院部分病區藥物進行管理,從藥師對ADC藥物管理程序、使用ADC管理病區藥物時的相關措施及使用ADC後的效果評價(以8個病區使用ADC前後基數藥物種類、抗生素藥物調配平均時間、夜間醫囑調配數量為指標)等方面對其使用實踐進行介紹。結果藥師通過篩選入櫃藥物及制訂取藥流程等建立了ADC中藥物的管理方法;並通過建立藥品目錄、進行補貨與庫存管理、建立應急預案、加強監督檢查等實現了對病區ADC藥物的管理。與使用ADC前比較,8個病區基數藥物種類從平均43種增至194種(P<0.01);抗生素調配醫囑平均時間由36分鐘降至19分鐘(P<0.01);4個月的夜間急診藥房住院醫囑調配量為由1607條降至302條(P<0.01)。結論使用ADC管理病區藥物,不但提高了藥物使用便捷性、提升了護士使用病區藥物的效率,也提高了藥師的藥學服務質量,促進了患者的合理用藥,開啟了病區和藥房的新工作模式。

Objective To alter drug management in inpatient wards in order to improve the punctuality of nurses getting access to the prescribed medicines as well as encouraging medication appropriateness.Methods Several criteria were set in order to compare the effectiveness before and after the implementation of ADCs in 8 of the inpatient wards at Kiang Wu Hospital,Macao China,which include,the number of ward stocks,the average time spent on antibiotic dispensing,and the number of prescriptions that needed to be dispensed during out-of-hour period.The process on creating drug selections and organisation for these ADCs were also discussed in this article.Results The implementation of ADCs has made a clear and strong improvement on the stock management in inpatient wards by having carefully tailored selection of drugs for each of these wards,and by establishing standard operating procedures on stock management,re-stocking and emergency plan.After the utilisation of ADCs,the average number of ward stocks increased from 43 to approximately 194(P<0.01).As a result,the average time spent on dispensing antibiotics decreased from 36 minutes to 19 minutes(P<0.01),and the number of inpatient prescriptions that needed to be dispensed by the pharmacy during out-of-hour period dropped from 1607 to 302(P<0.01).Conclusion The implementation of ADCs has provided a brand new working environment for both nursing and pharmacy staff.A clear improvement on the efficacy and productivity were seen,as well as enhancement on drug management,medication punctuality and their appropriateness.