Duke University Hospital, Durham, NC, USA.
Loma Linda University Health, Loma Linda, CA, USA.
Am J Health Syst Pharm. 2024 Aug 19;81(17):e471-e477. doi: 10.1093/ajhp/zxae084.
The fast-paced environment of the emergency department (ED), with frequent admissions, discharges, and transfers, poses a challenge for pharmacy departments to effectively distribute and store medications. The purpose of this study is to propose a unique workflow of patient-specific medication delivery to the ED from a hospital pharmacy to reduce the number of missing medications resulting in medication messages and redispenses.
The medication delivery workflow proposed in this study consists of batching the preparation and distribution of patient-specific medications sent from the pharmacy to the ED in the 1 to 2 hours prior to their administration time. Chi-square analysis was completed to compare medication redispenses and "missing medication" messages before and after the intervention, with the significance level set at P < 0.05.
The percentage of redispensed medications was effectively decreased following implementation of the workflow change from 21.6% to 9.2% (P < 0.001), with unit doses having the greatest reduction (25.8% vs 6.1%, P < 0.001). Benefits of this workflow change were also illustrated through a reduction in the percentage of missing-medication messages sent by nursing staff from 97.7% to 93.9% (P < 0.001).
This study showed that implementation of standard, hourly batches of medications dispensed from the pharmacy to the ED resulted in a significant reduction in the total percentage of redispensed medications and missing-medication messages. The overall reduction in redispensed medications as a result of this innovative workflow change not only benefited nursing and pharmacy staff but can reduce medication waste and improve patient care through timely administration of medications.
急诊部（ED）的快节奏环境，频繁的入院、出院和转科，给药房部门有效分发和储存药物带来了挑战。本研究旨在提出一种独特的患者特定药物从医院药房输送到 ED 的工作流程，以减少因药物信息和重新配药而导致的缺药数量。
本研究提出的药物输送工作流程包括在给药前 1 至 2 小时内，将从药房发送到 ED 的患者特定药物进行批量准备和分发。完成卡方分析，以比较干预前后的重新配药和“缺药”信息，显著性水平设为 P < 0.05。
实施工作流程变更后，重新配药的百分比从 21.6%有效降低到 9.2%（P < 0.001），单位剂量的降幅最大（25.8%比 6.1%，P < 0.001）。通过减少护理人员发送的缺药信息的百分比（从 97.7%降至 93.9%），也说明了这种工作流程变更的好处（P < 0.001）。
本研究表明，从药房向 ED 分发标准化、每小时批量药物，可显著降低重新配药的总百分比和缺药信息的百分比。由于这种创新的工作流程变更，重新配药的总体减少不仅使护理和药剂师受益，而且可以通过及时给药来减少药物浪费和改善患者护理。
