智能药柜在中心药房麻精药品管理中的责任分担

Responsibility sharing of automated dispensing cabinet in the management of anesthesia and first class psychotropic drugs in central pharmacies

目的探索智能药柜(ADC)在麻醉和第一类精神药品(以下简称“麻精药品”)管理中的责任分担。方法通过包括观察、访谈和审查混合方法的探索性研究,观察2021年9月至2022年9月ADC实施期间粤北人民医院中心药房麻精药品管理日常业务,采访护士(n=19)、管理人员(n=2)和药房工作人员(n=23),并审查ADC实施期间12个月的操作记录,并收集在此期间与ADC有关的不良事件报告。数据分析侧重于四项主要的管理活动:保管与控制访问、记录使用、监控和不良事件报告及调查,共同评估ADC在麻精药品管理中的责任分担。结果ADC通过授权登录及操作留痕方式保管和监控麻精药品,通过电子文档分担了麻精药品管理中账册登记的任务,提高了账物管理效率。ADC在分担责任的同时,仍然面临账物不符、破损、登录不畅、网络中断等不良事件。不良事件发生率为0.41%,其中52.6%账物不符为药师操作不当或疏忽造成重复计数或遗漏,ADC的电子文档缩短了不良事件调查时间,提高了透明度和问责制。结论ADC在中心药房麻精药品管理中的责任分担超出了简单的时间节省或效率提高,合理的ADC程序以及药师团队共同分担麻精药品管理任务。

Objective Exploring the responsibility sharing of automated dispensing cabinet(ADC)in the management of anesthesia and first class psychotropic drugs(hereinafter referred to as"anesthetic drug").Methods Through a exploratory research that included a mixed method of observation,interview and review,observed the daily business of anesthetic drug management in the central pharmacy of Yue Bei People's Hospital from September 2021 to September 2022 during the implementation of ADC,interviewed nurses(n=19),managers(n=2)and pharmacy staff(n=23),the operation records of 12 months during the implementation of ADC were reviewed,and adverse event reports related to ADC during this period were collected.Data analysis focused on four main management activities:custody and control of access,record usage,monitoring and adverse event reporting and investigation,jointly assessing the responsibility sharing of ADC in the management of anesthesia drugs.Results ADC stored and monitored anesthetic drugs through authorized login and operation leaving traces,and shared the task of account registration in anesthetic drug management through electronic documents,improving the efficiency of account management.While sharing responsibility,ADC still faced adverse events such as discrepancies,damages,poor login,and network interruptions.The incidence rate of adverse events was 0.41%,of which 52.6%of discrepancies between accounts and materials were caused by pharmacists'improper operation or negligence,resulting in duplicate counting or omissions.ADC's electronic documents shorten the investigation time of adverse events,improved transparency and accountability.Conclusion The responsibility sharing of ADC in the management of anesthetic drugs in the central pharmacy goes beyond simple time savings or efficiency improvements.Reasonable ADC procedures and pharmacist teams work together to share anesthetic drug management tasks.