Roman Cristina, Poole Susan, Walker Catherine, Smit De Villiers, Dooley Michael J
Pharmacy Department, Alfred Hospital, Commercial Road, Melbourne Vic 3004, Australia; Emergency and Trauma Centre, Alfred Hospital, Commercial Road, Melbourne Vic 3004, Australia.
Pharmacy Department, Alfred Hospital, Commercial Road, Melbourne Vic 3004, Australia.
Australas Emerg Nurs J. 2016 May;19(2):112-7. doi: 10.1016/j.aenj.2016.01.004. Epub 2016 Mar 14.
There has been limited assessment of the impact that automated medication dispensing machines have on the medication administration process, particularly in Australian emergency departments. The aim of this study is to examine the change in medication retrieval times, number of medications retrieved and staff perceptions before and after the installation of automated dispensing machines in an Australian emergency and trauma centre.
A time and motion method recorded the time taken and number of medications retrieved from the medication room by emergency department staff, before and after the installation of two automated dispensing machines. Surveys were administered to staff members to elicit the perceived impact on clinical practice, utilising 5-point Likert scales.
A total of 954 medication retrievals (1030 medications) were recorded in the pre-implementation period and 842 (991 medications) in the post-implementation period. The mean time taken to retrieve any medication was significantly longer in the post-implementation period (+5.7s; p<0.01). For schedules 2, 3, 4 or unscheduled medications, the mean time increased by 26.9s (p<0.01), but decreased by 36.1s (p<0.01) for schedule 8 or 11 medications. The mean number of medications per retrieval increased slightly in the post implementation period (+0.10; p<0.01). Staff perceptions were that automated dispensing machines improve knowledge of medications on imprest (p=0.03) and reduced medication retrieval time (p<0.01).
This study found that the medication retrieval process was slower with automated dispensing machines for Schedules 2, 3, 4 and unscheduled medications, but quicker for Schedule 8 and 11 medications in an Australian emergency and trauma centre. Although retrieving medications took slightly longer overall, staff believed automated dispensing machines save time.
自动配药机对给药过程的影响评估有限，尤其是在澳大利亚的急诊科。本研究的目的是考察在澳大利亚一家急诊与创伤中心安装自动配药机前后，药品取药时间、取药数量以及工作人员看法的变化。
采用时间与动作研究方法，记录在安装两台自动配药机前后，急诊科工作人员从药房取药所花费的时间和取药数量。通过使用5级李克特量表对工作人员进行调查，以了解其对临床实践的感知影响。
实施前阶段共记录了954次取药（1030种药品），实施后阶段记录了842次取药（991种药品）。实施后阶段取任何一种药品的平均时间显著延长（增加5.7秒；p<0.01）。对于第2、3、4类或非预定药品，平均时间增加了26.9秒（p<0.01），但对于第8或11类药品，平均时间减少了36.1秒（p<0.01）。实施后阶段每次取药的平均药品数量略有增加（增加0.10；p<0.01）。工作人员认为自动配药机提高了对备用药品的了解（p=0.03）并减少了取药时间（p<0.01）。
本研究发现，在澳大利亚一家急诊与创伤中心，对于第2、3、4类和非预定药品，使用自动配药机时取药过程较慢，但对于第8和11类药品则较快。尽管总体上取药花费的时间略长，但工作人员认为自动配药机节省了时间。
