J Am Pharm Assoc (2003). 2024 Sep-Oct;64(5):102143. doi: 10.1016/j.japh.2024.102143. Epub 2024 Jun 5.
Initiation of pharmacy automation and automated dispensing cabinets (ADCs) in hospitals has been shown to improve clinical, operational, and economical outcomes. Implementation of ADCs in surgical areas has lagged behind that of traditional inpatient hospitals settings.
To assess the documented impact of ADCs in ambulatory surgery centers (ASCs), perioperative, and surgical care areas.
A systematic literature review (SLR) was conducted in PubMed and Google Scholar in November 2022. The SLR was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Original research studies were included if they reported empirical data on ADCs in ASCs, perioperative areas, and surgical settings. The search criteria consisted of site locations in North America or Europe, with articles written in English and published since 1992. Outcomes of the studies were categorized as medication errors, controlled substance discrepancies, inventory management, user experience, and cost effectiveness.
A total of nine studies met the inclusion criteria. Six assessed ADC impact on controlled-substance inventory management, with all finding reductions in controlled-substance discrepancies ranging from 16% to 62.5%. Two studies showed a reduction in medication errors from 23% in 1 study and to up to 100% after ADC implementation in the other. Three studies revealed a positive impact on user experience, with a range of 81% to 100% of health care providers across these settings being satisfied with ADC usage. Only 1 study showed post-ADC implementation labor cost savings due to reduction in labor hours, but was based on data from 3 decades ago.
ADC implementation in surgical settings was found to decrease medication errors, reduce controlled-substance discrepancies, improve inventory management, enhance user experience, and reduce labor hours although the evidence consisted of smaller-scale studies. Larger-scale studies are needed to support these findings, thereby fostering a more comprehensive view of the multifactorial impact of ADCs in these settings.
在医院中引入药剂学自动化和自动化配药柜（ADCs）已被证明可以改善临床、运营和经济方面的结果。与传统住院医院环境相比，ADCs 在外科领域的实施落后了。
评估 ADC 在门诊手术中心（ASCs）、围手术期和外科护理领域的记录影响。
2022 年 11 月，在 PubMed 和 Google Scholar 中进行了系统文献综述（SLR）。根据系统评价和荟萃分析的首选报告项目进行了 SLR，并进行了报告。如果研究报告了 ASC、围手术期和手术环境中 ADC 的经验数据，则纳入原始研究。搜索标准包括北美或欧洲的地点，使用英语撰写的文章，且发表时间在 1992 年以后。研究的结果被归类为用药错误、管制药物差异、库存管理、用户体验和成本效益。
共有 9 项研究符合纳入标准。其中 6 项评估了 ADC 对管制药物库存管理的影响，所有研究都发现管制药物差异减少了 16%至 62.5%。2 项研究表明用药错误减少了，1 项研究中减少了 23%，另一项研究实施 ADC 后减少了 100%。3 项研究显示对用户体验有积极影响，这些环境中 81%至 100%的医疗保健提供者对 ADC 的使用感到满意。只有 1 项研究表明由于减少了劳动时间，在实施 ADC 后节省了劳动力成本，但该研究基于 30 年前的数据。
尽管证据来自规模较小的研究，但在外科环境中实施 ADC 被发现可以减少用药错误、减少管制药物差异、改善库存管理、提高用户体验和减少劳动时间。需要更大规模的研究来支持这些发现，从而更全面地了解 ADC 在这些环境中的多方面影响。
