Shelton Annie U, Wolf Matt, Franz Noah, Brummond Philip W
The University of Kansas Health System, Kansas City, KS.
Froedtert and the Medical College of Wisconsin, Milwaukee, WI.
Am J Health Syst Pharm. 2019 Jan 25;76(3):148-152. doi: 10.1093/ajhp/zxy018.
This study aims to show the feasibility and sustainability of technician barcode scanning verification as an alternative to pharmacist visual verification of first dose medications in an acute care setting.
A two-phase, noninferiority, single-center study was conducted to compare the accuracy of technician barcode scanning verification to pharmacist visual verification of pre-packaged first dose medications within a large acute care medical center. In phase 1, a pharmacy technician utilized barcode scanning as a means of verification. These preparations were then re-verified for accuracy by pharmacist visual verification. In phase 2, the verification order was reversed, starting with pharmacist visual verification of first doses, which were subsequently re-verified by a technician utilizing barcode scanning. Accuracy and efficiency (first dose processing time) of each phase was analyzed via error logs and retrospective dose tracking.
A total of 12,328 first dose preparations were included in the analysis and showed no difference between technician barcode scanning verification and pharmacist visual verification. Retrospective time study showed a 4-minute decrease in processing time when doses were verified by technician barcode scanning. Based on initial study outcomes, a variance was granted to pilot first dose tech-check-tech by the Wisconsin State Board of Pharmacy.
This study determined that there is no difference in verification accuracy between technician barcode scanning verification and pharmacist visual verification of first doses in an acute care setting. Through leveraging technology and skill mix, Froedtert Hospital was able to provide the same level of patient safety while decreasing pharmacy processing time, developing our technician workforce, and reallocating pharmacist staff from distributive roles in central pharmacy to decentralized clinical activities.
本研究旨在表明，在急性护理环境中，技术人员条形码扫描验证作为药剂师对首剂药物进行目视验证的替代方法的可行性和可持续性。
开展了一项两阶段、非劣效性、单中心研究，以比较在一家大型急性护理医疗中心内，技术人员条形码扫描验证与药剂师对预包装首剂药物进行目视验证的准确性。在第一阶段，药房技术人员利用条形码扫描作为验证手段。然后由药剂师进行目视验证，再次检查这些制剂的准确性。在第二阶段，验证顺序颠倒，首先由药剂师对首剂进行目视验证，随后由技术人员利用条形码扫描再次进行验证。通过错误日志和追溯剂量跟踪分析每个阶段的准确性和效率（首剂处理时间）。
分析共纳入12328剂首剂制剂，结果显示技术人员条形码扫描验证与药剂师目视验证之间无差异。回顾性时间研究表明，采用技术人员条形码扫描验证剂量时，处理时间减少了4分钟。基于初步研究结果，威斯康星州药房委员会批准了首剂技术人员检查技术人员的试点方案。
本研究确定了在急性护理环境中，技术人员条形码扫描验证与药剂师对首剂的目视验证在验证准确性方面没有差异。通过利用技术和技能组合，弗罗伊德特医院能够在降低药房处理时间、培养技术人员队伍以及将药剂师从中心药房的分发角色重新分配到分散的临床活动的同时，提供同等水平的患者安全保障。
