Rhodes James A M, McCarthy Bryan C, Scott Anthony C
UChicago Medicine, Chicago, IL, USA.
Lifespan Health System, Providence, RI, USA.
Hosp Pharm. 2022 Aug;57(4):526-531. doi: 10.1177/00185787211061380. Epub 2021 Dec 7.
Automated dispensing cabinets have the potential to create technology-induced errors that can arise during controlled substance medication dispensing. Despite enhancements made to the medication use process, the impact of ADC functionality on technology-induced controlled substance discrepancies have yet to be described.
To evaluate the impact of ADC functionality expansion on technology-induced errors such as controlled substance discrepancies created during "blind inventory counts" and cassette dispensing errors.
This quasi-experimental study was conducted over 18 months that evaluated the expanded use of dispensing cassettes within 8 ADCs at the University of Chicago Medicine. Unit-dose controlled substances with high usage were directed for inventory reassignment to cassettes. Controlled substance dispenses, blind inventory counts discrepancies and cassette dispensing errors were evaluated before and after cassette expansion. ADC discrepancy and Cassette Dispensing Error rates were calculated using 1-week segments across the study period.
Of the 64 040 dispenses during the study period, the proportion of cassette dispenses increased from 16% to 72% after cassette expansion. Controlled substance discrepancies decreased from 11 to 7 discrepancies for every 1000 dispenses ( < .0001). After cassette expansion, cassette dispensing errors increased to roughly 28 errors for every 1000 dispenses ( < .0001).
Expansion of ADC functionality created opportunities for reduced technology-induced controlled substance discrepancy rates at the expense of increased cassette dispensing errors.
自动配药柜有可能产生技术导致的错误，这些错误可能在管制药品配药过程中出现。尽管药物使用流程已得到改进，但自动配药柜功能对技术导致的管制药品差异的影响尚未得到描述。
评估自动配药柜功能扩展对技术导致的错误的影响，如“盲盘存计数”过程中产生的管制药品差异和药盒配药错误。
这项准实验研究历时18个月，评估了芝加哥大学医学中心8个自动配药柜中药盒使用的扩展情况。高使用量的单剂量管制药品被重新分配到药盒中进行盘存。在药盒扩展前后，对管制药品的配药、盲盘存计数差异和药盒配药错误进行了评估。在整个研究期间，以1周为时间段计算自动配药柜差异率和药盒配药错误率。
在研究期间的64040次配药中，药盒配药的比例在药盒扩展后从16%增加到72%。每1000次配药中管制药品差异从11次降至7次（<0.0001）。药盒扩展后，每1000次配药中，药盒配药错误增加到约28次（<0.0001）。
自动配药柜功能的扩展为降低技术导致的管制药品差异率创造了机会，但代价是药盒配药错误增加。
