Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester, M13 9PL, UK.
Department of Pharmacy and Pharmacology, University of Bath, Bath, UK.
Drug Saf. 2022 Aug;45(8):881-889. doi: 10.1007/s40264-022-01203-1. Epub 2022 Jul 15.
Avoidable harm associated with medication is a persistent problem in health systems and the use of preprogrammed infusion devices ('smart pumps') and data monitoring is seen as a core approach to mitigating and reducing the incidence of these harms. However, smart pumps are costly to procure, configure and maintain (in both human and financial terms) and are often poorly implemented. Variation in the manner in which medicines are prepared and used within complex modern healthcare systems exacerbates these challenges, and a strategic human-centred approach is needed to support their implementation. A symposium of 36 clinical and academic medication safety experts met virtually to discuss the current 'state of the art' and to propose strategic recommendations to support the implementation of medication administration technology to improve medication safety. The recommendations were that health systems (1) standardise infusion concentrations to facilitate the development of ready-to-administer formulations of frequently used medicines, and support 'out of the box' programming of infusion devices; (2) develop and implement drug libraries using human-centred approaches and the aforementioned standard concentrations, with a theoretical understanding of how devices are used in practice; (3) develop standardised metrics and outcomes to support the interpretation of data produced by infusion devices; (4) involve all stakeholders in the development of drug libraries and metrics to ensure broad understanding of the devices, their benefits and limitations; and (5) leverage input into device design, working with manufacturers and users. Using this strategic approach, it is then possible to envisage and plan real-world implementation studies using a uniform approach to quantify improvements in safety, efficiency and cost effectiveness.
与药物相关的可避免伤害是医疗体系中持续存在的问题，使用预编程输液设备（“智能输液泵”）和数据监测被视为减轻和减少此类伤害的核心方法。然而，智能输液泵的采购、配置和维护（从人力和财力两方面考量）成本高昂，且往往实施效果不佳。在复杂的现代医疗体系中，药物的准备和使用方式存在差异，这加剧了这些挑战，需要采取以人为核心的战略性方法来支持其实施。一个由 36 名临床和学术药物安全专家组成的专题研讨会以虚拟方式举行，讨论当前的“最新技术”，并提出支持药物管理技术实施以提高药物安全性的战略建议。这些建议是医疗体系（1）标准化输液浓度，以促进常用药物的即用型制剂的开发，并支持智能输液泵的“即插即用”编程；（2）采用以人为中心的方法和上述标准浓度开发和实施药物库，理论上了解设备在实际中的使用方式；（3）制定标准化的指标和结果，以支持对输液设备产生的数据进行解释；（4）让所有利益相关者参与药物库和指标的开发，以确保广泛了解设备、其益处和局限性；以及（5）利用输入来改进设备设计，与制造商和用户合作。通过采用这种战略性方法，就有可能设想并规划使用统一方法来量化安全性、效率和成本效益改进的实际实施研究。
