Jeffrey Emma, Walsh Áine, Hague Joseph, Lai Kit
Pharmacy Department, Level 1 Cheyne Wing, King's College Hospital NHS Foundation Trust, SE59RS London, United Kingdom.
Corporate Nursing, King's College Hospital NHS Foundation Trust, SE59RS London, United Kingdom.
Explor Res Clin Soc Pharm. 2024 Sep 7;16:100504. doi: 10.1016/j.rcsop.2024.100504. eCollection 2024 Dec.
Nursing medication administration is an integral, albeit time consuming component of a nursing shift. Automated dispensing cabinets (ADCs) are a medicines management solution designed to improve both efficiency and patient safety. This study aimed to evaluate the time taken to undertake a medication round including the number of locations visited to retrieve medicines, across four different clinical specialties within one hospital. Studies to date have investigated the effect of ADCs on nursing medication rounds centred around one clinical specialty, in hospitals with varying levels of digital maturity. This study adds to the existing body of evidence by investigating multiple clinical specialties where EPMA in use throughout the study period. In this study, prior to ADC implementation nurses retrieved required medicines from shelves in the medication room, mobile medication carts, and patients' own drug (POD) lockers. Post-ADC implementation, medicines were retrieved exclusively from the ADC and POD lockers only. Nurses were observed on each ward completing medication rounds, using the data collection tool designed for this study. Pre-implementation data was collected between February and June 2023, and post-implementation data collected between July and September 2023. There was a statistically significant reduction in the time required for medicines retrieval on the surgical ward only, post- ADC implementation. The time taken to retrieve each medication went from a mean of 98.1 s to 47.2 s ( = 0.0255). When comparing all four specialties as a whole, there was a reduction in the mean time required to issue each medicine preversus post-ADC implementation, from 83.3 s to 62.6 s respectively, however this difference was not shown to be statistically significant. The mean number of locations visited to obtain all required medicines for each patient reduced significantly from 1.73 to 1.04 ( < 0.01). There is potential for improved efficiency as nurses become more familiar with new workflows. It may be of benefit to repeat this study to ascertain whether time savings have been further improved.
护理用药管理是护理班次中不可或缺的一部分，尽管耗时较长。自动发药柜（ADC）是一种旨在提高效率和患者安全的药品管理解决方案。本研究旨在评估在一家医院的四个不同临床专科进行一次用药查房所需的时间，包括取药所访问的地点数量。迄今为止的研究调查了在数字成熟度不同的医院中，自动发药柜对以一个临床专科为中心的护理用药查房的影响。本研究通过调查在整个研究期间使用电子处方管理系统（EPMA）的多个临床专科，为现有证据体系增添了内容。在本研究中，在自动发药柜实施之前，护士从药房的货架、移动药车和患者自备药品（POD）储物柜中获取所需药品。自动发药柜实施后，仅从自动发药柜和POD储物柜中取药。使用为本研究设计的数据收集工具，观察每个病房的护士完成用药查房的情况。实施前的数据在2023年2月至6月期间收集，实施后的数据在2023年7月至9月期间收集。仅在外科病房，自动发药柜实施后，取药所需时间有统计学意义的减少。每种药物的取药时间从平均98.1秒降至47.2秒（P = 0.0255）。将所有四个专科作为一个整体进行比较时，自动发药柜实施前后发放每种药物所需的平均时间有所减少，分别从83.3秒降至62.6秒，然而这种差异未显示出统计学意义。为每位患者获取所有所需药品所访问的平均地点数量从1.73显著减少至1.04（P < 0.01）。随着护士对新工作流程更加熟悉，效率有提高的潜力。重复这项研究以确定节省时间是否进一步改善可能会有帮助。
