评估实施第一方数字图像捕获功能前后静脉内药物准备时间。

An evaluation of intravenous medication preparation times before and after implementation of first-party digital image capture functionality.

机构信息

Department of Information Services, Emory Healthcare, Atlanta, GA, USA.

Department of Pharmacy Services, Mayo Clinic Arizona, Phoenix, AZ, USA.

出版信息

Am J Health Syst Pharm. 2023 May 24;80(11):663-669. doi: 10.1093/ajhp/zxad044.

DOI:10.1093/ajhp/zxad044

PMID:36860163

Abstract

PURPOSE

The intravenous (IV) medication compounding workflow has long been associated with preventable medication errors. This has led to the development of technologies designed to enhance the safety of IV compounding workflows. Digital image capture is a component of this technology about which there is relatively limited published literature. This study evaluates image capture implemented within an electronic health record's existing first-party IV workflow solution.

METHODS

A retrospective case-control study was conducted to measure IV preparation times before and after digital imaging implementation. Preparations during 3 periods (preimplementation, ≤1 month post implementation, and >1 month post implementation) were matched for 5 variables. A less stringent analysis with matching for 2 variables, as well as an unmatched analysis, were performed post hoc. An employee survey assessed satisfaction with the digital imaging workflow, and revised orders were reviewed to identify new problems introduced by image capture.

RESULTS

A total of 134,969 IV dispenses were available for analysis. Median preparation time in the preimplementation and >1 month post implementation cohorts was unchanged in the 5-variable matched analysis (6.87 minutes vs 6.58 minutes, P = 0.14) and increased in the 2-variable matched analysis (6.98 minutes vs 7.35 minutes, P < 0.001) and unmatched analysis (6.55 minutes vs 8.02 minutes, P < 0.001). A large majority of survey respondents (92%) felt that image capture improved patient safety. Of the 105 postimplementation preparations identified as requiring revisions by the checking pharmacist, 24 (22.9%) required revisions directly related to camera functionality.

CONCLUSION

Implementation of digital image capture likely increased preparation times. Most IV room staff felt that image capture increased preparation times and were satisfied with how the technology improved patient safety. Image capture introduced camera-specific issues that led to preparations requiring revisions.

摘要

目的

静脉（IV）药物配制工作流程长期以来一直与可预防的药物错误有关。这导致了旨在增强 IV 配制工作流程安全性的技术的发展。数字图像采集是该技术的一个组成部分，关于该技术，已发表的文献相对较少。本研究评估了在电子病历现有第一方 IV 工作流程解决方案中实施的图像采集。

方法

进行了一项回顾性病例对照研究，以衡量数字成像实施前后 IV 准备时间。在 3 个时期（实施前、实施后≤1 个月和实施后>1 个月）匹配准备工作的 5 个变量。进行了后验的更宽松分析，匹配 2 个变量，以及不匹配分析。员工调查评估了对数字成像工作流程的满意度，并审查了修订后的订单，以识别图像采集引入的新问题。

结果

共有 134969 次 IV 分配可供分析。在 5 变量匹配分析中，实施前和实施后>1 个月的队列中准备时间中位数保持不变（6.87 分钟与 6.58 分钟，P = 0.14），在 2 变量匹配分析（6.98 分钟与 7.35 分钟，P < 0.001）和不匹配分析（6.55 分钟与 8.02 分钟，P < 0.001）中增加。绝大多数调查受访者（92%）认为图像采集提高了患者安全性。在 105 次实施后需要修订的准备中，有 24 次（22.9%）需要直接与摄像头功能相关的修订。