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在军事治疗机构中实施药剂师干预措施的个人数字助理记录。

Implementing personal digital assistant documentation of pharmacist interventions in a military treatment facility.

作者信息

Ford Stephen, Illich Stan, Smith Lisa, Franklin Arthur

机构信息

Military Vaccine Agency, 5113 Leesburg Pike, Suite 402, Falls Church, VA 22041-3204, USA.

出版信息

J Am Pharm Assoc (2003). 2006 Sep-Oct;46(5):589-93. doi: 10.1331/1544-3191.46.5.589.ford.

Abstract

OBJECTIVE

To describe the use of personal digital assistants (PDAs) in documenting pharmacists' clinical interventions.

SETTING

Evans Army Community Hospital (EACH), a 78-bed military treatment facility, in Colorado Springs.

PARTICIPANTS

Pharmacists on staff at EACH.

PRACTICE DESCRIPTION

All pharmacists at EACH used PDAs with the pilot software to record interventions for 1 month. The program underwent final design changes and then became the sole source for recording pharmacist interventions. The results of this project are being evaluated every 3 months for the first year and yearly thereafter.

PRACTICE INNOVATION

Visual CE (Syware Inc. Cambridge, Mass.) software was selected to develop fields for the documentation tool. This software is simple and easy to use, and users can retrieve reports of interventions from both inpatient and outpatient sections. The software needed to be designed so that data entry would only take a few minutes and ad hoc reports could be produced easily.

MAIN OUTCOME MEASURES

Number of pharmacist interventions reported, time spent in clinical interventions, and outcome of clinical intervention.

RESULTS

Implementing a PDA-based system for documenting pharmacist interventions across ambulatory, inpatient, and clinical services dramatically increased reporting during the first 6 months after implementation (August 2004-February 2005). After initial fielding, clinical pharmacists in advanced practice settings (such as disease management clinic, anticoagulation clinic) recognized a need to tailor the program to their specific activities, which resulted in a spin-off program unique to their practice roles.

CONCLUSION

A PDA-based system for documenting clinical interventions at a military treatment facility increased reporting of interventions across all pharmacy points of service. Pharmacy leadership used these data to document the impact of pharmacist interventions on safety and quality of pharmaceutical care provided.

摘要

目的

描述个人数字助理(PDA)在记录药剂师临床干预措施中的应用。

地点

位于科罗拉多斯普林斯的拥有78张床位的军事治疗机构埃文斯陆军社区医院(EACH)。

参与者

EACH的在职药剂师。

实践描述

EACH的所有药剂师使用装有试点软件的PDA记录干预措施,为期1个月。该程序经过了最终设计更改,随后成为记录药剂师干预措施的唯一来源。该项目的结果在第一年每3个月评估一次,此后每年评估一次。

实践创新

选择Visual CE(Syware公司,马萨诸塞州剑桥)软件来开发文档工具的字段。该软件简单易用,用户可以检索住院和门诊部门的干预报告。该软件的设计需要使数据录入仅需几分钟,并且可以轻松生成临时报告。

主要观察指标

报告的药剂师干预措施数量、临床干预所花费的时间以及临床干预的结果。

结果

实施基于PDA的系统来记录门诊、住院和临床服务中的药剂师干预措施,在实施后的前6个月(2004年8月至2005年2月)显著增加了报告数量。在初步投入使用后,高级实践环境(如疾病管理诊所、抗凝诊所)中的临床药剂师认识到需要根据其特定活动对该程序进行调整,这导致了一个与其实践角色独特相关的衍生程序。

结论

在军事治疗机构中,基于PDA的临床干预记录系统增加了所有药学服务点的干预报告。药学领导层利用这些数据记录药剂师干预措施对所提供药学护理的安全性和质量的影响。

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