Social and Clinical Pharmacy, University of Copenhagen, Copenhagen Ø, Denmark.
Copenhagen Academy for Medical Education and Simulation (CAMES), Center for Human Resources, Capital Region of Denmark, Herlev Hospital, Herlev, Denmark.
PLoS One. 2021 Feb 25;16(2):e0247499. doi: 10.1371/journal.pone.0247499. eCollection 2021.
Medicines used at Danish public hospitals are purchased through tendering. Together with drug shortage, tendering result in drug changes, known to compromise patient safety, increase medicine errors and to be resource demanding for healthcare personnel. Details on actual resources required in the clinic setting to manage drug changes are unknown. The aim of the study is to explore time spend by hospital personnel in a drug change situation when dispensing medicine to in- and outpatients in a hospital setting in the Capital Region of Denmark.
A time and motion study, using direct observation combined with time-registration tools, such as eye-tracking, video recording and manual time tracking. Data were obtained from observing nurses and social and health care assistants with dispensing authority while dispensing or extraditing medicine before and after the implementation of drug changes in two clinical setting; a cardiology ward and a rheumatology outpatient clinic.
Hospital personnel at the cardiology inpatient ward spent 20.5 seconds on dispensing a drug, which was increased up to 28.4 seconds by drug changes. At the rheumatology outpatient clinic, time to extradite medicine increased from 8 minutes and 6 seconds to 15 minutes and 36 seconds by drug changes due to tender. Similarly, drug changes due to drug shortage prolonged the extradition time to 16 minutes and 54 seconds. Statistical analysis reveal that drug changes impose a significant increase in time to dispense a drug for both in- and outpatients.
Clinical hospital personnel spent significantly longer time on drug change situations in the dispensing of medicine to in- and outpatients in a hospitals. This study emphasizes that implementing drug changes do require extra time, thus, the hospital management should encounter this and ensure that additional time is available for the hospital personnel to ensure a safe drug dispensing process.
丹麦公立医院使用的药物是通过招标采购的。与药品短缺一起，招标导致药品更换，这已知会危及患者安全，增加用药错误，并对医疗保健人员的资源需求。在临床环境中管理药品更换所需的实际资源的详细信息尚不清楚。本研究的目的是探讨在丹麦首都地区的医院环境中，向住院和门诊患者配药时，医院人员在药品更换情况下花费的时间。
采用时间和运动研究，使用直接观察与时间登记工具（如眼动追踪、视频记录和手动时间跟踪）相结合。数据是通过观察有配药权限的护士和社会和保健助理在两个临床环境（心脏病病房和风湿病门诊诊所）中实施药品更换前后配药或外配药物时获得的。
心脏病住院病房的医院人员配药时间为 20.5 秒，药品更换将其增加到 28.4 秒。在风湿病门诊，由于招标导致的药品更换使外配药物的时间从 8 分钟 6 秒增加到 15 分钟 36 秒。同样，由于药品短缺导致的药品更换使外配药物的时间延长至 16 分钟 54 秒。统计分析表明，药品更换会显著增加住院和门诊患者配药的时间。
临床医院人员在向住院和门诊患者配药时，在药品更换情况下花费的时间明显更长。本研究强调，实施药品更换确实需要额外的时间，因此，医院管理层应考虑到这一点，并确保为医院人员提供额外的时间，以确保安全的药品配药过程。
