Guerrero R M, Nickman N A, Jorgenson J A
University of Virginia Medical Center, Charlottesville, USA.
Am J Health Syst Pharm. 1996 Mar 1;53(5):548-54. doi: 10.1093/ajhp/53.5.548.
The impact of an automated dispensing system (ADS) on medication-related work activities by nurses and pharmacists was studied. A point-of-care ADS (Baxter Sure-Med) was installed on two nursing units (the surgical intensive care unit [SICU] and a medicine unit [4NMU]) of a 400-bed university hospital as part of a pilot project. A self-reported work-sampling study was used to collect observations of medication-related work activities by nurses, health unit coordinators (nursing support staff), and pharmacists for a seven-day period before ADS implementation and a seven-day period after implementation. There were 7797 observations of nurse work activities, 1408 observations of health unit coordinator work activities, and 4236 observations of pharmacist work activities. The percentage of nurse work activities that were medication related decreased from 20.7% before ADS implementation to 18.4% afterward on 4NMU and increased slightly from 10.8% to 11.0% on the SICU. Medication-related health unit coordinator work activities increased from 17.5% to 25.3% of total activities on 4NMU and decreased from 16.6% to 10.7% on the SICU. None of these changes was significant. For decentralized pharmacists supporting 4NMU, the percentage of work activities classified as clinical increased significantly from 36.5% to 49.1%. For decentralized pharmacists supporting the SICU, clinical activities increased from 27.9% to 35.1%. There were no significant changes on either unit in pharmacist activities classified as technical. An overall measure of the efficiency with which pharmacists used their time for patient care-related activities increased. A point-of-care ADS did not affect the proportion of time spent by nurses on medication-related activities and seemed to give pharmacists more time for clinical work.
研究了自动配药系统（ADS）对护士和药剂师与药物相关工作活动的影响。作为一个试点项目，在一家拥有400张床位的大学医院的两个护理单元（外科重症监护病房[SICU]和内科病房[4NMU]）安装了床边护理自动配药系统（百特Sure-Med）。采用自我报告的工作抽样研究方法，收集护士、健康单元协调员（护理支持人员）和药剂师在ADS实施前七天和实施后七天内与药物相关工作活动的观察数据。护士工作活动的观察数据有7797条，健康单元协调员工作活动的观察数据有1408条，药剂师工作活动的观察数据有4236条。在4NMU，与药物相关的护士工作活动百分比从ADS实施前的20.7%降至实施后的18.4%，而在SICU则从10.8%略有增加至11.0%。与药物相关的健康单元协调员工作活动在4NMU从总活动的17.5%增加到25.3%，在SICU从16.6%降至10.7%。这些变化均无统计学意义。对于支持4NMU的分散式药剂师，归类为临床工作的活动百分比从36.5%显著增加到49.1%。对于支持SICU的分散式药剂师，临床活动从27.9%增加到35.1%。两个单元中归类为技术工作的药剂师活动均无显著变化。药剂师用于患者护理相关活动的时间利用效率总体有所提高。床边护理自动配药系统并未影响护士在与药物相关活动上花费的时间比例，似乎为药剂师提供了更多时间用于临床工作。
