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[自动药品调配柜安全操作规范的实施分析]

[Analysis of the implementation of safety practices in the automated medication dispensing cabinets].

作者信息

Otero López M J, Bermejo Vicedo T, Moreno Gómez A M, Aparicio Fernández M A, Palomo Cobos L

机构信息

ISMP-España. Complejo Asistencial Universitario de Salamanca- IBSAL.

出版信息

Farm Hosp. 2013 Nov-Dec;37(6):469-81. doi: 10.7399/FH.2013.37.6.1053.

DOI:10.7399/FH.2013.37.6.1053
PMID:24256009
Abstract

OBJECTIVE

To determine the degree of implementation of recommended safety practices in the design and use of automated medication dispensing cabinets (ADCs) in Spanish hospitals.

METHODS

A descriptive study based on completion of the "Self- Evaluation Survey on the Safety of Automated Medication Dispensing Systems" from 10/10/2012 to 4/10/2013, at voluntarily participating hospitals. The survey contained 93 items grouped into 14 core processes.

RESULTS

In the 36 participating hospitals the average score for the completed survey was 307.8 points (66.2% of the highest possible score [LC 95% CI: 63.2-69.2]). The lowest scores were obtained for core processes 9, 12, 13, 8, 3, 4 and 11 referring to the establishment of guidelines for medication removed using the override function (28.4%), training for healthcare professionals (52%), risk management (53%), defining removal procedures (55.3%), use of ADCs in connection with electronic prescribing (60.9%), information that appears on ADC screens (61.8%) and eliminating medications being returned to ADCs (63.9%), respectively. The hospitals that used ADCs in connection with electronic prescribing as their principal system for distribution presented a higher level of implantation of safety practices than those that used ADCs as a complementary distribution system.

CONCLUSIONS

ADC installation has been accompanied by the implementation of various safety practices, but there are still numerous areas of risk for which technical, organizational, and system monitoring safety practices must be added in order to minimize errors with this technology.

摘要

目的

确定西班牙医院在自动药品调配柜(ADC)的设计和使用中推荐的安全措施的实施程度。

方法

在2012年10月10日至2013年10月4日期间,对自愿参与的医院进行一项基于完成“自动药品调配系统安全性自我评估调查”的描述性研究。该调查包含93个项目,分为14个核心流程。

结果

在36家参与调查的医院中,完成调查的平均得分为307.8分(占最高可能得分的66.2%[95%置信区间:63.2 - 69.2])。核心流程9、12、13、8、3、4和11的得分最低,分别涉及使用超控功能取出药品的指南制定(28.4%)、医护人员培训(52%)、风险管理(53%)、定义取出程序(55.3%)、与电子处方关联使用ADC(60.9%)、ADC屏幕上显示的信息(61.8%)以及消除退回ADC的药品(63.9%)。将与电子处方关联使用ADC作为主要调配系统的医院,其安全措施的实施水平高于将ADC作为补充调配系统的医院。

结论

ADC的安装伴随着各种安全措施的实施,但仍存在许多风险领域,必须增加技术、组织和系统监测安全措施,以尽量减少该技术的错误。

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