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OBJECTIVE To provide reference for improving the dispensing accuracy of similar drugs and reducing dispensing error risk through exploring the dispensing mode of similar drugs. METHODS The effectiveness and feasibility of the similar drug dispensing management mode was explored through adjusting the traditional horizontal or vertical sorting method to a “Z” shaped cargo location sorting， implementing similar drug in different zones dispensed by different people， and combining measures such as adjusting the format of drug dispensing documents and improving inventory methods. The role of similar drug dispensing mode in drug dispensing management was evaluated comprehensively from two aspects： work quality and work efficiency. RESULTS After the implementation of similar drug dispensing mode， total number of monthly dispensing errors （18.42±8.79 vs. 28.50±6.87，P= 0.005） and the proportion of monthly dispensing errors of similar drugs （[ 4.17±5.71）% vs. （10.96±7.05）%，P＝0.017] were significantly lower than before the implementation； the monthly consistency rate between accounts and materials （[ 98.46±0.73）% vs. （97.61±0.57）%， P＝0.004] was significantly higher than before implementation； completion time of dispensing in each batch was not significantly affected， and daily work was carried out smoothly and orderly. CONCLUSIONS The similar drug dispensing mode has a significant effect in improving the accuracy of dispensing similar drugs， reducing the risk of dispensing errors， and does not affect the efficiency of dispensing work.
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Background: Safe disposal of expired medicines is a problem which is current area of intense discussion among policy makers. This project was conducted to explore the knowledge, attitudes, and practices (KAP) among hospital pharmacies and drug store owners about expired medicines and their disposal. The information generated could be used to plan proper and safe drug disposal practices. Aims and Objectives: This project was conducted to explore the KAP among hospital pharmacies and drug store owners about expired medicines and their disposal. The information generated could be used to plan proper and safe drug disposal practices. Materials and Methods: The target population for the current project were the pharmacies dispensing drugs to patients. Pharmacies situated in the hospitals were also covered in this survey. KAP survey is designed to explore the present concepts about a topic of public interest in the target population. Results: The present study was conducted in 373 participants. Most of the participants (88.37%) believed that expired drugs should be returned to manufacturers and proper disposition is the responsibility of pharmacists (72.6%). However, few others believed that it should be cumulative responsibility of nursing professionals and municipal corporations as well. Most of the pharmacists were of opinion that expiry date is fixed by regulatory body (56.0%) and depends on storage conditions (59.2%) of drugs. Conclusion: An innovative policy needs to be implemented by the health regulators to strengthen the existing drug disposal policies more effectively.
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OBJECTIVE：To realize refined management of tablets i n the inpatient pharmacy ，and to ensure the medication safety of patients. METHODS ：Based on intelligent pharmacy ，the dispensing and packaging process under the automated drug dispensing and packaging system （ADDPS）mode was optimized and modified ；PDA barcode scanning technology was applied in all links of taking ，dismantling and adding ，so as to realize the real-time tracking of batch number and inventory ，and improve the drug closed-loop management of tablets. The error rate ，staff consumption time and pharmacist/nurse satisfaction were compared before and after the process improvement. RESULTS ：After the process improvement ，the dispensing error rate was decreased from 1.637‰ before improvement to 0.082‰（P＜0.01）；the staff consumption time decreased from （7.52±0.33）h to （5.11±0.24）h （P＜0.01）；the pharmacist/nurse satisfaction increased from 66.5％ to 93.4％（P＜0.01）. CONCLUSIONS ：Based on ADDPS ，the application of PDA barcode scanning technology standardizes the tablets management of inpatient pharmacy ，supplements and improves the drug closed-loop information ，realizes batch number tracking and inventory management ，reduces the occurrence of tablet dispensing errors ，improves the work efficiency and satisfaction of pharmacists ，and ensures the safety of clinical medication.
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OBJECTIVE：To pro vide reference for promoting the standardized construction of centralized intravenous drug dispensing mode and the healthy development of PIVAS and improving the rational infusion in China. METHODS ：The establishment and development process of PIVAS in China were reviewed ，the necessity ，current situation and problems to be solved of centralized intravenous drug dispensing mode were analyzed. RESULTS & CONCLUSIONS ：Due to scientific ， advanced，smooth，convenient operation procedure and standardized management ，and reduced occupation exposure ，centralized intravenous drug dispensing mode ，of which the pharmacists were in charge ，had become the inevitable development direction of intravenous drug dispensing in Chinese hospitals. The overall PIVAS construction in China had worked well and played a significant role，not only significantly improved the quality of finished infusion ，promoted rational drug use ，protected the health of nurses and ward （area） environment，but also contributed to the construction and development of the nursing profession ，and also contributed to the improvement of the pharmacy department ’s own management level. However ，the value of PIVAS pharmacist service still needs to be understood.
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Introduction: The accredited drug dispensing outlet(ADDO), popularly known in Swahili as Duka la DawaMuhimu (DLDM) are shops controlled by Pharmacy councilunder Pharmacy Act number 1 of 2011.The Act has specificpremise standards for ADDO shops, and the owners musthave a dispenser trained in ADDO programs. The purpose ofthis study was to determine the presence of selected essentialprescription medicines and trained dispensers in AccreditedDrug Dispensing Outlets shops.Material and methods: A cross section survey was conductedin 44 Accredited Drug Dispensing Outlets out of 46 in fiveDivisions of Hanang district in Manyara region northernTanzania. These Divisions were Balangda, Bassutu, Simbay,Endasack and Katesh.Results: The study found 44(82%) of the intervieweddispensers were trained in Accredited Drug Dispensing Outletsprograms. Also out of 14 selected essential prescriptionmedicines which were assessed, only 60% were available inthese shops.Conclusion: Availability of selected essential prescriptionmedicines is not adequate, as 40% of the assessed medicineswere not available, despite of 82% of Accredited DrugDispensing Outlets shops having trained dispensers, thereis still a significant percent (18%) of them which are run byuntrained dispenser posing risks of irrational treatment toclients of these shops.
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Objective To evaluate the application of self-made-dispensing-ampoule car in the medicine dispensing for venous transfusion. Methods The self-made-dispensing-ampoule car made based on the ergonomics is a temporary carrier device for medical waste in the need of the whole process of dispensing process. The overall exterior is made of 304 stainless steel, separated into 2 layers. The Upper layer has a frame with integral medicine glass hole made of stainless steel, which can be dismantled from the upper layer. The medicine glasses are small empty medicine bottles used to hold the dispensed medicine; while the lower layer is a slide platform which can put on 3 medical waste classification boxes. The bottom has universal wheels with brakes to help the car move and stop. To focus on 42 emergency department nurses using the device, to analyze their error rate of medicine dispensing, the dispensing time for the same batch of patients with same dosages and shuttle time from dispensing car to buffer room to pour medical waste and compare the data the year before and the year using the device. Results After using it, the dispensing error occurrence rate and nurses dispensing time and shuttle times of pouring waste were 0.31?(3/97 785) , (70.08±3.28) min/time, two times, which were all obviously lower than 1.95? (18/92 095) , (110.04 ± 6.91) min/time, 30 times without using it ( χ2=11.64, 204.16, t=71.70, all P< 0.01) . Conclusion Using the dispensing ampoule car can optimize the dispensing process in dispensing of venous transfusion, ensure patients with safe venous transfusion, raise the efficiency of nurses saving time and efforts.
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Objective@#To evaluate the application of self-made-dispensing-ampoule car in the medicine dispensing for venous transfusion.@*Methods@#The self-made-dispensing-ampoule car made based on the ergonomics is a temporary carrier device for medical waste in the need of the whole process of dispensing process. The overall exterior is made of 304 stainless steel, separated into 2 layers. The Upper layer has a frame with integral medicine glass hole made of stainless steel, which can be dismantled from the upper layer. The medicine glasses are small empty medicine bottles used to hold the dispensed medicine; while the lower layer is a slide platform which can put on 3 medical waste classification boxes. The bottom has universal wheels with brakes to help the car move and stop. To focus on 42 emergency department nurses using the device, to analyze their error rate of medicine dispensing, the dispensing time for the same batch of patients with same dosages and shuttle time from dispensing car to buffer room to pour medical waste and compare the data the year before and the year using the device.@*Results@#After using it, the dispensing error occurrence rate and nurses dispensing time and shuttle times of pouring waste were 0.31 ‱ (3/97 785), (70.08±3.28) min/time, two times, which were all obviously lower than 1.95‱ (18/92 095), (110.04±6.91) min/time, 30 times without using it (χ2=11.64, 204.16, t=71.70, all P<0.01).@*Conclusion@#Using the dispensing ampoule car can optimize the dispensing process in dispensing of venous transfusion, ensure patients with safe venous transfusion, raise the efficiency of nurses saving time and efforts.
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Objective To develop a pharmacy device for drug counting and dispensing.Methods The device was composed of four parts of dispensing tank, hook, support frame and separator, which was made of bamboo and metal. The multi application of the separators contributed to fulfilling the functions of the device.Results The device gained advantages over the traditional mode in time,accuracy,drug loss and the staff's efficiency.Conclusion The device is easy to manufacture and operate and behaves well in feasibility, practicability and innovation, and thus is worthy promoting practically. [Chinese Medical Equipment Journal,2018,39(5):47-49]
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OBJECTIVE: To shorten drug dispensing time of inpatient pharmacy in our hospital, and to enhance the quality of pharmaceutical care.METHODS: The activity of quality control circle (QCC) was carried out by using "shorten drug dispensing time of inpatient pharmacy" as subject. According to the steps of QCC activity, key links and factors that influence the of drug dispensing time in the inpatient pharmacy were found out. Countermeasures were formulated and implemented according to practical reasons. The activity was evaluated by using the drug dispensing time in every 100 medical orders before and after QCC activity. RESULTS: According to the links of "dispensing medical order" and "checking medical order" that spent longest time, the countermeasures were put forward to improve work efficiency, such as rational drug distribution and design, opmitization of the dispensing route, realizing electronic large infusion prescription by strengthening system informatization, strengthening the management of confusing drugs, strengthening staff training and establishing performance appraisal system. The drug dispensing time was shortened from 43. 99 min (before QCC) to 21. 77 min (after QCC), and target achievement rate was 99. 24％. QCC staff showed positive growth in means, responsibility, team cohesion and other aspects. CONCLUSIONS: QCC activity can shorten the time of drug dispensing, improve work efficiency and pharmacist' s ability of solving problem, and help to improve pharmaceutical care in the inpatient pharmacy.
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OBJECTIVE:To provide reference for improving drug dispensing speed of pharmacy intravenous admixture services (PIVAS).METHODS:The reasons for slow drug dispensing in PIVAS of our hospital were analyzed,quality control circle (QCC) activity was conducted according to ten steps as subject selection,plan formulation,current situation control,goal setting,goal analysis,countermeasure formulation,countermeasure implementation and review,effect confirmation,standardization,review and improvement.The effect of QCC activity was evaluated by drug dispensing speed and the rate of drug dispensing error.RESULTS:Main reasons for slow drug dispensing in PIVAS in our hospital included not fixed position of the infusion bag,insufficient pre-dispensing drug basket,not unified method of sticking doctor's order labels,not eye-catching drag position identification,unreasonable drug shelf position.Drug dispensing speed increased from 2.99 bag/person/min to 4.90 bag/person/min,and the target yield rate was 95％ through displacing injection according to the doctor's order,re-making the drug shelf logo,preparing adequate pre-dispensing basket in advance,sticking the prescription tag of medical order standardly,etc.The rate of drug dispensing error decreased from 0.005％ to 0.002％ after improving and optimizing drug dispensing procedure.CONCLUSIONS:The application of QCC activity,improvement and optimization of drug dispensing procedure in PIVAS in our hospital not only improve drug dispensing speed in PIVAS,but also reduce the rate of drug dispensing error.
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OBJECTIVE: To evaluate the costs and patient safety of a pilot implementation of an automated dispensing cabinet in a critical care unit of a private tertiary hospital in São Paulo/Brazil. METHODS: This study considered pre- (January-August 2013) and post- (October 2013-October 2014) intervention periods. We considered the time and cost of personnel, number of adverse events, audit adjustments to patient bills, and urgent requests and returns of medications to the central pharmacy. Costs were evaluated based on a 5-year analytical horizon and are reported in Brazilian Reals (R$) and US dollars (USD). RESULTS: The observed decrease in the mean number of events reported with regard to the automated drug-dispensing system between pre- and post-implementation periods was not significant. Importantly, the numbers are small, which limits the power of the mean comparative analysis between the two periods. A reduction in work time was observed among the nurses and administrative assistants, whereas pharmacist assistants showed an increased work load that resulted in an overall 6.5 hours of work saved/day and a reduction of R$ 33,598 (USD 14,444) during the first year. The initial investment (R$ 206,065; USD 88,592) would have been paid off in 5 years considering only personnel savings. Other findings included significant reductions of audit adjustments to patient hospital bills and urgent requests and returns of medications to the central pharmacy. CONCLUSIONS: Evidence of the positive impact of this technology on personnel time and costs and on other outcomes of interest is important for decision making by health managers.
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Humans , Equipment and Supplies, Hospital/economics , Intensive Care Units/economics , Medication Systems, Hospital/economics , Pharmacy Service, Hospital/economics , Pharmacy Service, Hospital/methods , Tertiary Care Centers/economics , Brazil , Cost-Benefit Analysis , Equipment and Supplies, Hospital/statistics & numerical data , Health Care Costs , Intensive Care Units/statistics & numerical data , Medication Systems, Hospital/statistics & numerical data , Pharmacy Service, Hospital/statistics & numerical data , Reproducibility of Results , Retrospective Studies , Tertiary Care Centers/statistics & numerical data , Time FactorsABSTRACT
Objective:To optimize the storage placement of drug in automatic dispensing machine so as to increase the dispensing speed and work efficiency.Methods: The drugs were dispensed on the up and down side of the center of axle wire from high to low according to the dispensed frequency. The application regularity of various drugs was analyzed by using a number of prescription information and the relevant drugs were stored in nearest tank aroundthe drug outlet as the principle of minimum time algorithm. Through optimizing the storage placement of automatic dispensing machine and applying average dispensing time as evaluation index, the change of average dispensing time between before and after 3 months of the optimization of storage placement was analyzed.Results: After the storage placement was optimized, average dispensing time was shortened 2.0s. And the difference of the time between before and after optimization was statistically significant (t=11.92,P<0.05). Conclusion: Through applying minimum time algorithm, the optimized storage placement of automatic dispensing machine shortens the dispensing time of prescription and increases work efficiency.
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OBJECTIVE:To discuss the application of rational drug use software system in drug dispensing in outpatient depart-ment of our hospital. METHODS:The application of rational drug use software system (included clinical decision support soft-ware,drug dispensing software and drug management software) in prescribing (warning in advance),dispensing (intervention in the event)and the prescription review(the post review)in outpatient department of our hospital were all introduced. Outpatient pre-scription checking and intervention were collected from our hospital after the application of rational drug use software system to evaluate the effect of the software system. RESULTS & CONCLUSIONS:Rational drug use software system is adopted to realize scientific,convenient and express monitoring and management of prescription drug use in advance,in the course and afterwards. A total of 721 507 outpatient prescriptions were checked in our hospital from Jan. to May in 2015;0.17‰prescriptions were intercept-ed by system warning;system pointed out and pharmacists had checked 23.25% prescriptions;the rate of qualified prescription was more than 99.96%. After pharmacists intervention,various types of irrational prescriptions decreased significantly (P<0.01). It is suggested that pharmacists should make full use of information system,at the same time,optimize and improve the system through active exploration so as to improve rational drug use.
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OBJECTIVE:To provide suggestions for solving the problem of hospital pharmacy waiting time for medicine. METHODS:The definition and classification of the response time in hospital pharmacy dispensing process were introduced. The re-sponse time was considered to analyze the causes of waiting time for medicine in outpatient pharmacy and central pharmacy. The scheme for shortening the waiting time for medicine were put forward. RESULTS&CONCLUSIONS:The response time can be di-vided into 2 types,i.e. relative invariable and relative variable;the former results from hardware factor,system factor and other factors,and is relative stable and hardly changed;the latter results from that the speed of previous step is higher than that of next step,and can be changed by certain method,such as adjusting the proportion of manpower allocation,adjusting manpower tempo-rarily. Based on the concept of response time,the essence of waiting time for medicine can be understood accurately and deeply, and countermeasure can be found out fundamentally and used for other steps as prescribing prescription.
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OBJECTIVE:To promote standard management of drugs in ICU area. METHODS:The change of work mode in ICU area of our hospital was analyzed and compared after the application of automated drug dispensing system(ADDS)as well as the change of related indicators 3 months before and after the application of ADDS;the effect of ADDS was evaluated. RESULTS& CONCLUSIONS:After the application of ADDS,the management of base drugs changed from open management to intelligent, closed-off and authority management;drug storage and cost management became more scientific,and staff allocation became more optimal. Under the condition of zero difference in the number of medical orders,initial medication time shortened from 170 min to 131 min (P<0.05),time of daily drug preparation and drug repercussion shortened from (81.20 ± 3.56)min to (30.04 ± 7.55) min,and (9.18 ± 2.79)min to (6.47 ± 4.66) min (P<0.05). The application of ADDS can improve work efficiency,standardize drug management,promote medical safety,and provide reference for initiating a new mode of drug management in wards.
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The aim of the present work was to assess the adherence to medication from polymedicated patients before and after the use of a Drug-dispensing System with Usage Control (DDSUC) and compare the levels of the clinical parameters - blood pressure, postprandial glycemia, glycated hemoglobin, triglycerides and cholesterol. DDSUC consisted of a monthly drug-dispensing package, in the shape of a blister with a calendar. This quasi-experimental study was performed in a Basic Health Unit. Twenty four patients were selected to use DDSUC for 4 months. Medication adherence was assessed through Morisky-Green test. Among the participants of the study, 62.5% were women and the average age was 67 years old. Before the use of DDSUC, 83.3% of the patients were considered as "less adherent". After the use of the system, 100% were considered as "more adherent" (p < 0.01), the means of the systolic blood pressure decreased 23.7 mmHg (p=0.000), the diastolic blood pressure decreased 12.1 mmHg (p=0.004) and glycemia diminished 79.3 mg/dl (p=0.000). The use of DDSUC improved the adherence to medication and decreased the values of the clinical parameters, making patients safer when it comes to respecting the correct use of their medication...
O objetivo deste estudo foi avaliar a adesão ao tratamento medicamentoso de pacientes polimedicados antes e após o uso de um Sistema de Dispensação de Medicamentos e Controle de Uso (SDMCU) e comparar os níveis dos parâmetros clínicos - pressão arterial, glicemia pós-prandial, hemoglobina glicada, triglicérides e colesterol. O SDMCU foi constituído por uma embalagem mensal de dispensação de medicamentos, em forma de
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Humans , Male , Female , Aged , Pharmaceutical Services/supply & distribution , Medication Adherence , Clinical Trial , Metabolic Diseases/therapyABSTRACT
OBJECTIVE:To explore the reasons and countermeasures of discrepancy of the account in inventory management of automatic single dose drug dispensing machine. METHODS:The discrepancy information of using sub charter in the process of inventory management from Feb. to Jun. 2014(before management)was collected,the causes were analyzed and countermeasures were put forward and carried out;then management results were evaluated via the discrepancy information from Jul. to Nov. 2014 (after management). RESULTS & CONCLUSIONS:For the relative discrepancy factors such as peeling medicine,adding medi-cine and recording information,etc.,which appeared in each link,the management was strengthened in terms of drug,machine and personnel like limiting scattered drug product rules,modifying the machine parameters settings,strengthening the training and testing of machine operators;and deliver inside account discrepancy rate was decreased from 3.34% to 0.79%. Improvement of the relative system with effective countermeasures can reduce the account sub charter discrepancy rate.
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OBJECTIVE:To optimize the drug placement in the automated drug dispensing machine to improve work efficien-cy. METHODS:Based on the principle of the minimum time algorithm,the drug which would be used at a high frequency was placed in the drug storage tank nearest to the drug outlet. Meanwhile,the rule of drug use was drawn from the information on a large number of prescriptions,based on which the drugs correlated with each other were placed in the drug storage tanks that were adjacent. With daily time it takes to add drugs,average time it takes to make up a prescription and the maximum number of drugs stored as the evaluated indexes,the initial drug placement in the automated drug dispensing machine was optimized. The changes in the indexes within 3 months before and after the above-mentioned optimization were statically analyzed. RESULTS:After calculat-ing the three-dimensional sizes of the packages of drugs and the dispensing frequency data of the previous year,354 drugs were se-lected and placed in the nearer or farther storage tanks in the automated dispensing machine according to the dispensing frequency and the correlation among them. After the optimization of the placement,daily time it takes to add drugs reduced by 54 min(218 vs. 165 min)on average,average time it takes to make up a prescription reduced by 8 s(24 vs.16 s)and the maximum number of drugs stored increased by 1 333 boxes(13 113 vs. 14 446 boxes)on average. There was statistical significance in differences(P<0.05). CONCLUSIONS:The initial drug placement in the automated drug dispensing machine that was optimized by minimum time algorithm has reduced daily time it takes to add drugs and average time it takes to make up a prescription and increased the maximum number of drugs stored and thus improved work efficiency.
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OBJECTIVE:To establish a new semi-automatic drug dispensing mode,with proper cost,which falls in between full-automatic drug dispensing mode and manual drug dispensing mode,good work efficiency,standard and simple operation meth-od and meets national laws and regulations. METHODS:A semi-automatic drug dispensing system was designed,in which the in-formation in the drug dispensing sheet could be automatically printed on the drug bag,and automatic bagging,packaging and deliv-ery of drugs were realized. Such drug dispensing system included hardware(mechanical structures such as drug turntable and drug funnel,transmission device,etc.)and software control systems(the program of interface with hospital information system,micro control unit software,computer software,etc.). Through commissioning,formal operation and statistics,based on 18 oral drug dis-pensing sheets with the same contents,calculated the time of drug dispensing and the number of drug dispensing errors by 3 phar-macists respectively in manual drug bag dispensing mode and semi-automatic drug dispensing mode,to evaluate the effect of the semi-automatic drug dispensing system. RESULTS:From commissioning in May 2012 to formal operation in September 2012,the system operated normally and utility model patents were obtained. In the two modes,the total time of drug dispensing was 481 and 397 min (t=6.82,P<0.001),the numbers of drug dispensing errors were 25 and 7 (χ2=9.353 8,P=0.002 2),respectively. There was statistical significance. CONCLUSIONS:The semi-automatic drug dispensing system has higher efficiency and less num-ber of drug dispensing errors compared with manual drug bag dispensing mode and lower cost compared to full-automatic drug dis-pensing system. It deserves promotion.
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OBJECTIVE:To discuss the mode and feasibility of informatization and automation construction in the inpatient pharmacy. METHODS:The practice of informatization and automation construction of inpatient pharmacy in our hospital was intro-duced,as well as the change of drug dispensing model. The influence of them on drug dispensing process was analyzed. RESULTS&CONCLUSIONS:2 automatic single dose tablets dispense packing machines,2 rapid dispensing machines and 2 automatic injec-tion chests are introduced in automatic inpatient pharmacy of our hospital. The informatization construction contain the establish-ment of inpatient pharmacy database,drug dispensing and recheck,the application of code,etc. Due to the implementation of auto-matic drug dispensing information system,drug dispensing mode have changed,i.g. drug dispensing by area instead of wards;in-jection and large volume transfusion are dispensed by wards;oral preparation and discharge medication are dispensed by prescrip-tion;dispensed drugs are distributed to wards with professional logistics. The implementation of informatization and automation of inpatient pharmacy in our hospital improve pharmaceutical administration and pharmaceutical care,and add automatic expiry date management and code tracking to guarantee the accuracy,timeliness and high efficiency of drug dispensing.