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OBJECTIVE To provide a reference for establishing an automatic checking mode and improving the checking efficiency of the unit dose dispensing system of oral drugs in hospital. METHODS The automatic checking process reengineering team was established in our hospital. ECRSI method was adopted to sort out the verification process and mode of drug bags for the unit dose formula of our hospital through five principles of eliminating， combining， rearranging， simplifying and increasing， and the hardware series problem and the problem of excessive system false-positive proportion were optimized. The drug bags for the unit dose formula were randomly selected from 10 wards， the efficiency and external error rates of manual check and automatic checking mode before and after optimization were compared， and the false-positive reporting failure in automatic checking mode was also compared before and after optimization. RESULTS After the establishment of the automatic checking mode of the unit dose formula for oral drugs， the average checking time of drug bags was significantly shorter than that of manual checking mode in the other 8 wards except for cardiovascular and renal departments （P＜0.05）. After the optimization of the automatic checking mode， the average checking time of drug bags in all wards was significantly shorter than that in manual checking mode （P＜0.05）. Compared with before optimization of the automatic checking mode， the average checking time of drug bags was shortened by 0.43 s， and the average checking time of drug bags in half of the wards was shortened significantly （P＜0.05）. At the same time， the false-positive proportion decreased from 96.83% before optimization to 92.76% after optimization （P＜0.05）. The external error rate dropped from 0.039‰ in manual checking mode to 0.019‰ before optimization and 0.015‰ after optimization （P＜0.05）. CONCLUSIONS Based on ECRSI method， the automatic checking mode for the unit dose dispensing system of oral drugs can effectively reduce the average checking time of drug bags， reduce external error and improve the work efficiency of pharmacists.
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El sistema de distribución de medicamentos en dosis unitarias es un método de dispensación y control de la medicación en servicios de salud,es organizado y coordinado por la farmacia institucional. Objetivo.Analizar los factores asociados para el procedimiento de administración de medicamentos mediante el sistema de dosis unitaria en el hospital de Instituto Ecuatoriano Seguridad Social de la ciudad de Babahoyo. Metodología. Diseño observacional, descriptivo de corte transversal. Institución: Hospital del IESS. Revisión sistemática documental nacional e internacional sobre SDUM y la aplicación de una encuesta a la población objetivo del estudio: 92 médicos, 118 enfermeras, 2 químicos farmacéuticos. Resultados.Confirmaron que el sistema tradicional afecta la racionalización de medicamentos; existiendoescasez de recursos humanos, espacio físico inadecuado, incumplimiento de normas vigentes.Serequiere la capacitación del recurso humano en el 100%. Existiendo la necesidad imperiosa de implementar el sistema de dosis unitaria en el 100% de los servicios de hospitalización del IESS Babahoyo. Conclusión.Los factores que mayor incidencia tienen en la implementación del nuevo sistema son conocimiento del sistema, las normas legales y reglamentación farmacéutica y el número insuficiente de profesionales químicos farmacéuticos especializados, a esto se une el factor presupuesto a nivel central que influye en la adquisición de equipamiento e implementación de las áreas funcionales según el Acuerdo Ministerial 00000569 del 6 de julio de 2011 Norma para la Aplicación del Sistema de Dispensación/Distribución de Medicamentos por Dosis Unitaria -Ministerio de Salud Pública, enero 2013.
Introduction.The system of distribution of medications in unit doses is a method of dispensing and control of medication in health services is organized and coordinated by the institutional pharmacy. Objective.To analyze the factors associated with the benefits of the medication administration procedure through the unit dose system at the Instituto Ecuatoriano Seguridad Social in the city of Babahoyo. Methodology. Observational design, descriptive cross-section. Institution: IESS Hospital. Systematic national and international documentaryreview on SDUM and the application of a survey to the target population of the study: 92 doctors, 118 nurses, 2 pharmaceutical chemists. Results They confirmed that the traditional system affects the rationalization of medicines; There is a shortage of human resources, inadequate physical space, non-compliance with current regulations. 100% human resource training is required. There is a pressing need to implement the unit dose system in 100% of the IESS hospitalization services. Babahoyo.Conclusion: The factors that have the greatest impact on the implementation of the new system are knowledge of the system, legal regulations and pharmaceutical regulation and the insufficient number of specialized pharmaceutical chemists, to this is added the budget factor at the central level that influences the acquisition of equipment and implementation of the functional areas according to the Ministerial Agreement 00000569 of July 6, 2011 Standard for the Application of the Dispensing System / Distribution of Drugs by Unit Dose -Ministry of Public Health, January 2013.
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Humans , Pharmaceutical Preparations , Medication Therapy Management , Medication Systems , Population , Rationalization , Specialty Uses of Chemicals , Controlled Before-After StudiesABSTRACT
Objective To Improve inpatient safety of oral drugs , and reduce risk of medication errors .Methods 1 696 oral-order errors caused by prescription and transcription from July to December 2012 were investigated by Excell.Results 979 cases (57.7%) reduced the efficiency of unit-dose automated dispensing machines and 717 cases (42.3%) affected to inpatients’ medica-tion safety.Conclusion It is very important that pharmacists should check drugs packaged unit -dose with prescription paper .It is also an effect means to prevent medication errors that continuing training pharmacists′skill, intensifying communication with clinics and strengthening information technology systems .
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INTRODUCTION AND OBJECTIVES: Many dispensing errors occur in the hospital, and these can endanger patients. The purpose of this study was to assess the rate of dispensing errors by a unit dose drug dispensing system, to categorize the most frequent types of errors, and to evaluate their potential clinical significance. METHODS: A prospective study using a direct observation method to detect medication-dispensing errors was used. From March 2007 to April 2007, "errors detected by pharmacists" and "errors detected by nurses" were recorded under six categories: unauthorized drug, incorrect form of drug, improper dose, omission, incorrect time, and deteriorated drug errors. The potential clinical significance of the "errors detected by nurses" was evaluated. RESULTS: Among the 734 filled medication cassettes, 179 errors were detected corresponding to a total of 7249 correctly fulfilled and omitted unit doses. An overall error rate of 2.5 percent was found. Errors detected by pharmacists and nurses represented 155 (86.6 percent) and 24 (13.4 percent) of the 179 errors, respectively. The most frequent types of errors were improper dose (n = 57, 31.8 percent) and omission (n = 54, 30.2 percent). Nearly 45 percent of the 24 errors detected by nurses had the potential to cause a significant (n = 7, 29.2 percent) or serious (n = 4, 16.6 percent) adverse drug event. CONCLUSIONS: Even if none of the errors reached the patients in this study, a 2.5 percent error rate indicates the need for improving the unit dose drug-dispensing system. Furthermore, it is almost certain that this study failed to detect some medication errors, further arguing for strategies to prevent their recurrence.
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Aged, 80 and over , Female , Humans , Male , Cardiovascular Diseases/drug therapy , Medication Errors/statistics & numerical data , Medication Systems, Hospital/statistics & numerical data , Pharmacy Service, Hospital/standards , France , Medication Systems, Hospital/standards , Prospective StudiesABSTRACT
OBJECTIVE:To offer suggestions for domestic hospitals in the introduction of automated unit-dose dispensing equipment.METHODS:The application value and problems arose from the introduction of automated unit-dose dispensing machine were analyzed by summarizing our experience and reviewing literature.RESULTS:The use of automatic machines could avoid drug pollution and cross infection and reduce the incidence of medication errors during drug dispensing and administration.However,its application has also resulted in problems such as additional machine errors more costs and management difficulties.The introduction of the machine should be based on rational demands and proof analysis.Moreover,it is more suitable for the unit-dose dispensing in inpatient dispensary.CONCLUSIONS:Automatic drug dispensing is the trend of development.The application of new equipment can bring new problems as well as challenges,thus it is urgent to explore new management model.
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OBJECTIVE:To supply the reference for benchmarking framework of unit dose dispensing(UDD).METHODS:To introduce the running module and the training mode for UDD pharmacists of the UDD management mode,and the working quality was controlled using 6? management pattern.RESULTS & CONCLUSIONS:The benchmarking framework of UDD is feasible in practice and it can help guarantee dispensing accuracy,improve the quality of pharmaceutical care.
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PURPOSE: It is important to select and use kinds of Inhaler appropriate to the age of the patient and severity of symptoms. Several kinds of Inhaler have been developed and recommended according to each inhaler's resistance and usage method. We evaluated the usable age of 4 inhalers (turbulent flow inhalers, multi unit dose inhalers, breath actuated MDI, and autohalers) by measuring peak inspiratory flow(PIF) using In-Check(TM) Inspiratory Flow Meter. METHODS: Ninety three patients aged from 3 to 7 years(mean 57+/-12.9 mo.) who had admitted to CHA hospital from July 2000 to April 2001 were enrolled. Study patients were divided into 4 groups according to age:3-4 years of age(group A, n=31), 4-5 years of age(group B, n=32), 5-6 years of age(group C, n=18), and 6-7 years of age(group D, n=12). RESULTS: Out of total 93 patients, 23(71%), 27(84%), 17(94%) patients of each group A, B, C and all 12 patients of group D could use the 4 types of inhaler through adequated education. In all four groups, height, body weight and age were significantly correlated(P<0.05). Usable age, height and weight of children who can use turbulent flow inhaler(TFI) were each 8 year 7 month old, 144 cm, 32.0 kg, and those of multi unit dose inhaler(MUD) were 2 year 10 month old, 92 cm, 12.0 kg. Also that of breath-actuated MDI were 1 yr 8 months, 83 cm, 8.5 kg and that of autohaler were 2 yr 8 months, 91 cm, 11.0 kg. CONCLUSION: We concluded that the ability to use inhalers correlated with height, weight and age of the patients. Multi unit dose inhalers, Breath actuated MDI and Autohaler are useful after 3 years of age through adequate education.
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Child , Humans , Infant , Body Height , Education , Nebulizers and VaporizersABSTRACT
The object of this study was to compare the drug administration errors on a ward using unit dose drug administration with a control ward using the traditional drug distribution system. Data were collected both before and after using the unit dose drug distribution system between February and May 1994. Single blind study was used in the data collection and data were collected by observation using a proven form and inappropriate work systems on the wards. The study showed that on using the unit dose drug distribution system on the experimental ward for eight weeks, drug administration errors were significantly decreased; average drug administration errors which had been 28.20% when using the traditional drug distribution system fell to 6.88% when using the unit dose drug distribution system. The three leading types of drug administration errors were omission error, wrong dose error and unauthorized drug error. N the unit dose drug distribution system these error rate were 5.74%, 1.00% and 0.14% respectively whereas rates in the traditional drug distribution system were 16.00%, 5.68% and 6.31% respectively. The major causes of drug administration errors in the two drug distribution systems were personnel errors, unskilled staff and inappropriate work systems on the wards.
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OBJECTIVE:To provide reference for the generalization of automatic unit-dose tablet sorting and counting machine (ATM) in hospital pharmacy. METHODS: The preparative work and the working procedure of the ATM were introduced, and the advantages, the causes of medication errors and the problems related to the application of the ATM were analyzed. RESULTS: ATM helped to enhance the dispensing efficiency, improve the sanitation of drugs, ensure drug safety to great extent and improve the drug control. However, sometimes it might bring about medication errors. 236 (0.48%) of the total 49 059 medical orders analyzed in our study were found to be of medication errors. CONCLUSIONS: ATM has great application value. The wide use of ATM is consistent with the tendency of pharmacy automation, yet its use remains to be further improved.