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首页> 外文期刊>The Canadian journal of hospital pharmacy. >Decentralized Automated Dispensing Devices: Systematic Review of Clinical and Economic Impacts in Hospitals
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Decentralized Automated Dispensing Devices: Systematic Review of Clinical and Economic Impacts in Hospitals

机译：分散式自动点胶设备：对医院临床和经济影响的系统评价

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Background: Technologies have been developed over the past 20 years to automate the stages of drug distribution in hospitals, including ordering, dispensing, delivery, and administration of medications, in attempts to decrease medication error rates. Decentralized automated dispensing devices (ADDs) represent one such technology that is being adopted by hospitals across Canada, but the touted benefits, in terms of improved patient safety and cost savings, are increasingly being questioned. Objective: To summarize and evaluate the existing literature reporting the clinical and economic impacts of using decentralized ADDs in hospitals. Data Sources: A literature search was conducted in MEDLINE, Embase, and all evidence-based medicine databases for the years 1992 to 2012 to identify English-language articles reporting on the use of ADDs in hospital wards. Study Selection and Data Extraction: All randomized controlled trials, observational studies, before-and-after studies, time series analyses, cost-effectiveness and cost-benefit analyses, and review articles were considered for inclusion. Studies evaluating pharmacy-based ADDs, such as bar code-based medication dispensing carousels, automated dispensing shelves, and combinations of various dispensing modalities, were excluded. Data Synthesis: Of 175 studies initially identified, 8 were retained for evidence synthesis. It appears that ADDs were effective in reducing medication storage errors and the time that nurses spent taking inventory of narcotics and controlled substances. There was no definitive evidence that using ADDs increased the time that nurses or pharmacists spent with patients, reduced medication errors resulting in patient harm, or reduced costs in Canadian hospitals. However, pharmacy technicians spent more time stocking the machines. Conclusion: ADDs have limited potential to decrease medication errors and increase efficiencies, but their impact is highly institution-specific, and use of this technology requires proper integration into an institutions medication distribution process. Before deploying this technology, it is recommended that Canadian hospitals carefully examine their current systems and the benefits they hope to gain with the changes. ^g>automated dispensing device, medication errors, costs
机译：背景技术：在过去的20年中，已经开发出一些技术来使医院中的药物分配过程自动化，包括订购，分配，递送和管理药物，以降低药物错误率。分散式自动配药设备（ADD）代表了一种这样的技术，该技术已在加拿大各地的医院中采用，但是在提高患者安全性和节省成本方面，吹捧的益处日益受到质疑。目的：总结和评估现有文献，报道在医院中使用分散式ADD的临床和经济影响。数据来源：在1992年至2012年期间，在MEDLINE，Embase和所有循证医学数据库中进行了文献检索，以鉴定报告医院病房中ADD使用情况的英文文章。研究选择和数据提取：所有随机对照试验，观察性研究，前后研究，时间序列分析，成本效益和成本效益分析以及评价文章均纳入考虑范围。排除了评估基于药房的ADD的研究，例如基于条形码的药物分配转盘，自动分配架以及各种分配方式的组合。数据综合：在最初确定的175个研究中，保留了8个用于证据综合。看来ADDs可以有效减少药物存储错误，并减少护士花费的麻醉品和管制药物清点时间。没有确凿的证据表明，使用ADD可以增加护士或药剂师与患者共处的时间，减少因用药错误而造成的患者伤害，或可以降低加拿大医院的成本。但是，药房技术人员花了更多时间来存放机器。结论：ADDs在减少用药错误和提高效率方面的潜力有限，但其影响是高度针对机构的，因此使用该技术需要适当整合到机构用药的分配过程中。在部署这项技术之前，建议加拿大的医院仔细检查他们当前的系统以及他们希望从变更中获得的收益。 ^ g>自动分配装置，用药错误，费用

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