Ringold D J, Santell J P, Schneider P J
Atkinson Graduate School of Management, Willamette University, Salem, OR, USA.
Am J Health Syst Pharm. 2000 Oct 1;57(19):1759-75. doi: 10.1093/ajhp/57.19.1759.
Results of the 1999 ASHP national survey of pharmacy practice in acute care settings that pertain to drug dispensing and administration practices are presented. Pharmacy directors at 1050 general and children's medical-surgical hospitals in the United States were surveyed by mail. The response rate was 51%. About three-fourths of respondents described their inpatient pharmacy's distribution system as centralized. Of those with centralized distribution, 77.4% indicated that their system was not automated. Decentralized pharmacists were used in 29.4% of the hospitals surveyed; an average of 58.9% of their time was spent on clinical, as opposed to distributive, activities. About 67% of directors reported pharmacy computer access to hospital laboratory data, 38% reported access to automated medication-dispensing-unit data, and 19% reported computer access to hospital outpatient affiliates. Only 13% of hospitals had an electronic medication order-entry system; another 27% reported they were in the process of developing such a system. Decentralized medication storage and distribution devices were used in 49.2% of hospitals, while 7.3% used bedside information systems for medication management. Machine-readable coding was used for inpatient pharmacy dispensing by 8.2% of hospitals. Ninety percent reported a formal, systemwide committee responsible for data collection, review, and evaluation of medication errors. Virtually all respondents (98.7%) reported that their staff initiated manual reports. Only two thirds tracked these reports and reported trends to the staff. Fewer than 15% reported that staff were penalized for making or contributing to an error. Pharmacists are making a significant contribution to the safety of medication distribution and administration. The increased use of technology to improve efficiency and reduce costs will require that pharmacists continue to focus on the impact of changes on the safety of the medication-use system.
本文呈现了1999年美国卫生系统药师协会（ASHP）针对急症护理机构中与药品调配和给药实践相关的药学实践进行的全国性调查结果。通过邮件对美国1050家综合及儿童内科外科医院的药房主任进行了调查。回复率为51%。约四分之三的受访者称其住院药房的配送系统为集中式。在采用集中配送的受访者中，77.4%表示其系统未实现自动化。29.4%的受调查医院使用了分散式药师；他们平均将58.9%的时间用于临床活动而非配送活动。约67%的主任报告称药房计算机可访问医院实验室数据，38%报告可访问自动药品调配单元数据，19%报告计算机可访问医院门诊附属机构数据。只有13%的医院拥有电子医嘱录入系统；另有27%报告称他们正在开发此类系统。49.2%的医院使用了分散式药品储存和配送设备，而7.3%使用床边用药管理信息系统。8.2%的医院在住院药房调配中使用了机器可读编码。90%报告称有一个负责数据收集、审查和评估用药错误的正式全系统委员会。几乎所有受访者（98.7%）报告称其工作人员发起了手工报告。只有三分之二跟踪这些报告并向工作人员报告趋势。不到15%报告称工作人员因犯错或导致错误而受到处罚。药师正在为药品调配和给药的安全做出重大贡献。为提高效率和降低成本而增加技术的使用将要求药师继续关注这些变化对用药系统安全的影响。
