Schmidt K A, Schlesinger M D
Department of Anesthesiology, Hackensack Medical Center, New Jersey 07601.
Anesthesiology. 1993 Jan;78(1):184-90. doi: 10.1097/00000542-199301000-00025.
Drug abuse is a leading occupational hazard for operating room personnel. Easy access to controlled substances allows drug dependence to develop and flourish. A system that accurately audits the distribution of controlled substances used in the operating room may decrease the onset of drug abuse and make it easier to identify drug addicts. A simple, inexpensive, and reliable system that improves accountability of controlled substances is described in detail.
This system involves participation by anesthesiologists, operating room nurses, and pharmacists to accurately record amount and type of drugs dispensed, used, wasted, and returned. Periodic, random, qualitative, and quantitative analyses of drugs returned for wastage are performed.
In the first 6 months in which the system was used, 6,336 patients were treated and 7,182 ampules of controlled substances were dispensed. Thirty-seven incident reports describing deviations from the protocol occurred. In each case an explanation for the discrepancy was determined and compliance with the protocol was subsequently improved. No cases of drug diversion were discovered or suspected.
The system described is simple and inexpensive to implement and has improved accountability for controlled substance management.
药物滥用是手术室工作人员面临的主要职业危害。容易获取管制药品会使药物依赖得以形成并蔓延。一个能准确审计手术室使用的管制药品分发情况的系统，可能会减少药物滥用的发生，并使识别吸毒者变得更容易。本文详细介绍了一个简单、廉价且可靠的能提高管制药品问责制的系统。
该系统需要麻醉医生、手术室护士和药剂师共同参与，准确记录所分发、使用、浪费及归还的药品数量和种类。对归还以作浪费处理的药品进行定期、随机、定性和定量分析。
在使用该系统的前6个月里，共治疗了6336例患者，分发了7182支管制药品安瓿。出现了37份描述偏离规程情况的事件报告。针对每一例差异都确定了原因，随后规程的遵守情况得到了改善。未发现或怀疑有药品挪用的情况。
所描述的系统实施起来简单且成本低廉，并且提高了管制药品管理的问责制。
