Department of Pharmacy, St. Jansdal Hospital, Postbus 138, 3840 AC Harderwijk, The Netherlands
Am J Health Syst Pharm. 2012 Oct 1;69(19):1659-64. doi: 10.2146/ajhp110503.
The effects of a direct refill program for automated dispensing cabinets (ADCs) on medication-refill errors were studied.
This study was conducted in designated acute care areas of a 386-bed academic medical center. A wholesaler-to-ADC direct refill program, consisting of prepackaged delivery of medications and bar-code-assisted ADC refilling, was implemented in the inpatient pharmacy of the medical center in September 2009. Medication-refill errors in 26 ADCs from the general medicine units, the infant special care unit, the surgical and burn intensive care units, and intermediate units were assessed before and after the implementation of this program. Medication-refill errors were defined as an ADC pocket containing the wrong drug, wrong strength, or wrong dosage form.
ADC refill errors decreased by 77%, from 62 errors per 6829 refilled pockets (0.91%) to 8 errors per 3855 refilled pockets (0.21%) (p < 0.0001). The predominant error type detected before the intervention was the incorrect medication (wrong drug, wrong strength, or wrong dosage form) in the ADC pocket. Of the 54 incorrect medications found before the intervention, 38 (70%) were loaded in a multiple-drug drawer. After the implementation of the new refill process, 3 of the 5 incorrect medications were loaded in a multiple-drug drawer. There were 3 instances of expired medications before and only 1 expired medication after implementation of the program.
A redesign of the ADC refill process using a wholesaler-to-ADC direct refill program that included delivery of prepackaged medication and bar-code-assisted refill significantly decreased the occurrence of ADC refill errors.
研究自动化配药柜（ADC）直接补充计划对药物补充错误的影响。
本研究在一家 386 床位的学术医疗中心的指定急症护理区进行。2009 年 9 月，该医疗中心的住院药房实施了批发商到 ADC 的直接补充计划，包括药物的预包装交付和条形码辅助 ADC 补充。在实施该计划之前和之后，评估了普通内科病房、婴儿特别护理病房、外科和烧伤重症监护病房以及中级病房的 26 个 ADC 中的药物补充错误。药物补充错误定义为 ADC 口袋中含有错误的药物、错误的强度或错误的剂型。
ADC 补充错误从 62 个错误/6829 个补充口袋（0.91%）减少到 8 个错误/3855 个补充口袋（0.21%）（p <0.0001）。干预前检测到的主要错误类型是 ADC 口袋中药物错误（错误的药物、错误的强度或错误的剂型）。在干预前发现的 54 种错误药物中，有 38 种（70%）装在多药物抽屉中。实施新的补充流程后，3 种错误药物装在多药物抽屉中。实施该计划前有 3 例过期药物，实施后只有 1 例过期药物。
通过批发商到 ADC 的直接补充计划，重新设计 ADC 补充流程，包括预包装药物的交付和条形码辅助补充，显著减少了 ADC 补充错误的发生。
