Cousein Etienne, Mareville Julie, Lerooy Alexandre, Caillau Antoine, Labreuche Julien, Dambre Delphine, Odou Pascal, Bonte Jean-Paul, Puisieux François, Decaudin Bertrand, Coupé Patrick
Department of Pharmacy, Valenciennes General Hospital, Valenciennes, France.
J Eval Clin Pract. 2014 Oct;20(5):678-84. doi: 10.1111/jep.12202. Epub 2014 Jun 11.
RATIONALE, AIMS AND OBJECTIVES: To assess the impact of an automated drug distribution system on medication errors (MEs).
Before-after observational study in a 40-bed short stay geriatric unit within a 1800 bed general hospital in Valenciennes, France. Researchers attended nurse medication administration rounds and compared administered to prescribed drugs, before and after the drug distribution system changed from a ward stock system (WSS) to a unit dose dispensing system (UDDS), integrating a unit dose dispensing robot and automated medication dispensing cabinet (AMDC).
A total of 615 opportunities of errors (OEs) were observed among 148 patients treated during the WSS period, and 783 OEs were observed among 166 patients treated during the UDDS period. ME [medication administration error (MAE)] rates were calculated and compared between the two periods. Secondary measures included type of errors, seriousness of errors and risk reduction for the patients. The implementation of an automated drug dispensing system resulted in a 53% reduction in MAEs. All error types were reduced in the UDDS period compared with the WSS period (P<0.001). Wrong dose and wrong drug errors were reduced by 79.1% (2.4% versus 0.5%, P=0.005) and 93.7% (1.9% versus 0.01%, P=0.009), respectively.
An automated UDDS combining a unit dose dispensing robot and AMDCs could reduce discrepancies between ordered and administered drugs, thus improving medication safety among the elderly.
原理、目的和目标:评估自动药品分发系统对用药错误的影响。
在法国瓦朗谢讷一家拥有1800张床位的综合医院内一个有40张床位的短期老年病房进行前后观察性研究。研究人员参加护士给药查房,并比较在药品分发系统从病房库存系统(WSS)转变为单剂量配药系统(UDDS)(集成单剂量配药机器人和自动药品配药柜(AMDC))之前和之后的给药与处方药物情况。
在WSS期间治疗的148名患者中总共观察到615次错误机会(OE),在UDDS期间治疗的166名患者中观察到783次OE。计算并比较了两个时期的用药错误(MAE)率。次要指标包括错误类型、错误严重程度以及患者的风险降低情况。自动药品分发系统的实施使MAE减少了53%。与WSS时期相比,UDDS时期所有错误类型均有所减少(P<0.001)。错误剂量和错误药物的错误分别减少了79.1%(2.4%对0.5%,P=0.005)和93.7%(1.9%对0.01%,P=0.009)。
结合单剂量配药机器人和AMDC的自动UDDS可以减少医嘱药物与给药药物之间的差异,从而提高老年人的用药安全性。