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基于HIS的住院摆药单优化与摆药差错预警系统的设计与应用
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| 篇名： | 基于HIS的住院摆药单优化与摆药差错预警系统的设计与应用 |
| TITLE： | |
| 摘要： | 目的：提高住院药房摆药工作效率、减少摆药差错。方法：介绍我院住院摆药单的优化及建立的摆药差错预警系统，通过设计试验对比5名药师使用优化前后的摆药单调配10张摆药单的调配时间、取药行走步数和差错率，以及预警系统上线前（2016年）、后（2017年）同期发生的预警拦截差错次数等，评价本系统的使用效果。结果：在原摆药单信息的基础上对其信息进行重新编排，添加对应的药位码、识别码等，并将摆药单上的药品顺序按本药房贮存位置顺序排列；根据本药房的药品包装规格，将取药数量由“n支”换算成“x盒y支”的形式。所建系统利用计算机编程和条形码技术采用扫码器在药师调配药品时自动扫描佩戴的手环条形码并与摆药单上信息绑定，实现实时预警摆药差错及摆药时对零散注射剂的核对；两种调配方式比较，使用优化后摆药单5名药师调配10张摆药单的时间缩短了27.9％（P＜0.01），取药行走步数减少了28.6％（P＜0.01），但两种方式差错率相似（P＞0.05）；预警系统2017年3月－12月共拦截差错1 321次，摆药出现的品规差错与2016年度同期相比，从0.07％降低到0.001％，调剂人员从21人降低到18人。结论：摆药单的优化及预警系统的建立及应用，在提高摆药效率的同时减少了因摆药差错引起的医疗不良事件的潜在风险。 |
| ABSTRACT： | OBJECTIVE： To improve the efficiency of drug dispensing and reduce dispensing error in the inpatient pharmacy. METHODS： The optimization of dispensing list and the estblishment of dispensing error early warning system in our hospital was introduced. The effects of the system were evaluated through comparing dispensing time， walking step of taking medicine and error rate among 10 dispensing lists of 5 pharmacists used by using dispensing list before and after optimization in trials， and times of early warning interception errors occurred in the same period before （2016） and after （2017） using the system. RESULTS：Based on the information of original drug list， information rearrangement， addition of corresponding drug position code and identification code were conducted by using computer programming and bar code technology. The drugs in the list were arranged according to storage location of the pharmacy. The quantity of drug was converted from “n branch” to “x box y branch” according to drug package and specification in our pharmacy. The bar code of the hand ring was scanned automatically by using computer programming technology and bar code reader when pharmacists dispensed drugs； the information of it was tied to the information on the dispensing list to achieve real-time early warning of dispensing errors .The established system could check scattered injection. Compared with 2 dispensing modes，the dispensing time was decreased by 27.9％ （P＜0.01）， walking step of taking medicine was decreased by 28.6％ （P＜0.01） in mode by using dispensing list after optimization， error rate was similar （P＞0.05） in 2 modes. By the end of 2017， the total number of intercepted errors was 1 321 since Mar. 2017. The error rate of specification was reduced from 0.07％ to 0.001％ during the same period of 2016. The staff was reduced from 21 to 18. CONCLUSIONS： The establishment and application of the system not only improve drug dispensing efficiency but also reduce the potential risk of dispensing error-induced severe medical event. |
| 期刊： | 2018年第29卷第19期 |
| 作者： | 温正旺，董佳宁，梁鹏，刘彦刚#，刘维峰，杨文月，李娜 |
| AUTHORS： | WEN Zhengwang，DONG Jianing，LIANG Peng，LIU Yangang，LIU Weifeng，YANG Wenyue，LI Na |
| 关键字： | 住院药房；条形码技术；摆药差错预警系统；摆药单；优化 |
| KEYWORDS： | Inpatient pharmacy； Bar code technology； Dispensing error early warning system； Dispensing list； Optimization |
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