Vigoda Michael M, Gencorelli Frank J, Lubarsky David A
Center for Informatics and Perioperative Management, Department of Anesthesiology, Perioperative Medicine and Pain Management, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA.
Anesth Analg. 2007 Oct;105(4):1061-5, table of contents. doi: 10.1213/01.ane.0000282021.74832.5e.
Accurate recording of disposition of controlled substances is required by regulatory agencies. Linking anesthesia information management systems (AIMS) with medication dispensing systems may facilitate automated reconciliation of medication discrepancies.
In this retrospective investigation at a large academic hospital, we reviewed 11,603 cases (spanning an 8-mo period) comparing records of medications (i.e., narcotics, benzodiazepines, ketamine, and thiopental) recorded as removed from our automated medication dispensing system with medications recorded as administered in our AIMS.
In 15% of cases, we found discrepancies between dispensed versus administered medications. Discrepancies occurred in both the AIMS (8% cases) and the medication dispensing system (10% cases). Although there were many different types of user errors, nearly 75% of them resulted from either an error in the amount of drug waste documented in the medication dispensing system (35%); or an error in documenting the medication in the AIMS (40%).
A significant percentage of cases contained data entry errors in both the automated dispensing and AIMS. This error rate limits the current practicality of automating the necessary reconciliation. An electronic interface between an AIMS and a medication dispensing system could alert users of medication entry errors prior to finalizing a case, thus reducing the time (and cost) of reconciling discrepancies.
监管机构要求准确记录管制药品的处置情况。将麻醉信息管理系统（AIMS）与药品调配系统相连接，可能有助于自动核对药品差异。
在一家大型学术医院进行的这项回顾性调查中，我们回顾了11603例病例（涵盖8个月的时间段），比较了记录为从我们的自动药品调配系统中取出的药品（即麻醉药品、苯二氮䓬类、氯胺酮和硫喷妥钠）记录与在我们的AIMS中记录为已给药的药品记录。
在15%的病例中，我们发现已调配药品与已给药药品之间存在差异。差异出现在AIMS（8%的病例）和药品调配系统（10%的病例）中。虽然存在许多不同类型的用户错误，但其中近75%是由药品调配系统中记录的药品浪费量错误（35%）；或在AIMS中记录药品时的错误（40%）导致的。
相当比例的病例在自动调配和AIMS中都存在数据录入错误。这种错误率限制了当前自动进行必要核对的实用性。AIMS与药品调配系统之间的电子接口可以在病例最终确定之前提醒用户药品录入错误，从而减少核对差异的时间（和成本）。
