Francois Olivia, Hufschmid Thurnherr Edith, Blatrie Cedric, Cousein Etienne, Herranz Ana, Sadeghipour Farshid, Bonnabry Pascal
Pharmacy, Geneva University Hospitals, Geneve, Switzerland
institut für Spitalpharmazie, Inselspital Universitatsspital Bern, Bern, Switzerland.
Eur J Hosp Pharm. 2025 Jun 24;32(4):354-360. doi: 10.1136/ejhpharm-2024-004195.
Automated dispensing cabinets (ADCs) offer improved medication safety, greater efficiency and return on investment. However, integrating ADCs into medication dispensing processes can be challenging in complex hospital environments. This study aimed to draft suggestions to help hospitals adopt ADCs.
Two-day visits were organised in seven European hospitals operating ADCs. Investigators used an observational grid, a questionnaire and interviews, each divided into the themes of medication processes before and after the introduction of ADCs, the major steps followed and the resources involved, ergonomics and staff perceptions.
ADCs were integrated into four global hospital medication dispensing systems (packs of drugs are distributed from the central pharmacy to wards for dispensing) and three nominative systems-that is, patient-specific ones (drug doses prescribed for individuals are distributed from the central pharmacy to wards with ADC as supplementary stock). A general ADC project implementation timeline was shaped: main drivers of automation to initiate the project, visit of other sites, pilot test (with IT integration and staff training), and evaluation phase (satisfaction, safety, efficiency) to justify a possible expansion. Users (7 pharmacists, 21 nurses, 7 data engineers) identified facilitators (such as a dedicated project manager, a pilot phase, an intuitive device), barriers and any improvements needed (training for incoming staff, reorganisation of ward workflow, dynamic inventories).
Despite their diverse pharmacy organisations, each hospital raised similar challenges and reported analogous major steps in project implementation. Although integration processes are complex, ADCs rapidly provide users with benefits. By following the practical advice and recommendations from these hospitals, new adopters might reduce the risks of failed ADC projects and accelerate their integration.
自动发药柜(ADCs)可提高用药安全性、提升效率并带来投资回报。然而,在复杂的医院环境中将自动发药柜整合到药品调配流程中可能具有挑战性。本研究旨在起草建议以帮助医院采用自动发药柜。
对七家使用自动发药柜的欧洲医院进行了为期两天的访问。研究人员使用了观察网格、问卷和访谈,每项均分为引入自动发药柜前后的用药流程、遵循的主要步骤和涉及的资源、人体工程学以及工作人员看法等主题。
自动发药柜被整合到四种全球医院药品调配系统(成包药品从中心药房分发到病房进行调配)和三种实名制系统,即针对特定患者的系统(为个体开具的药物剂量从中心药房分发到病房,自动发药柜作为补充库存)。形成了一个通用的自动发药柜项目实施时间表:启动项目的自动化主要驱动因素、参观其他场所、试点测试(包括信息技术整合和工作人员培训)以及评估阶段(满意度、安全性、效率),以证明可能的扩展是合理的。用户(7名药剂师、21名护士、7名数据工程师)确定了促进因素(如专职项目经理、试点阶段、直观的设备)、障碍以及任何所需的改进措施(对新入职员工的培训、病房工作流程的重组、动态库存)。
尽管各医院的药房组织各不相同,但每家医院都提出了类似的挑战,并报告了项目实施中类似的主要步骤。虽然整合过程很复杂,但自动发药柜能迅速为用户带来益处。通过遵循这些医院的实用建议,新采用者可能会降低自动发药柜项目失败的风险,并加速其整合。