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首页> 外文期刊>The International journal of pharmacy practice >The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist's time and activities
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The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist's time and activities

机译：闭环电子处方和自动分配系统对病房药剂师时间和活动的影响

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Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P=0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P<0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P< 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.
机译：目的评估闭环电子处方和自动配药系统对提供病房药房服务所花费的时间以及所开展活动的影响。设置外科病房，伦敦教学医院。方法所有数据均在干预前两个月和干预后一年收集。首先，病房药剂师记录了每天花的时间，共四个星期。其次，使用二维工作采样在10个工作日内进行了观察性研究，以确定病房药​​剂师的活动。最后，检查了药品订单，以确认药剂师的认可，这些认可应该已经并且实际上已经制定。主要发现提供平日病房药房服务的平均时间从每天1小时8分钟增加到每天1小时38分钟（P = 0.001;未配对t检验）。处方监测，建议更改治疗/监测，提供建议或信息以及非生产时间的时间显着增加。供应减少，寻找图表和检查患者自己的药物减少了。与医疗和药学人员以及“自我”一起度过的时间有所增加。干预前和干预后100％的患者可以对患者用药记录中的78％进行评估。干预前的787份药物订单中有390份（50％）需要签注，之后的897份中190份（21％）需要签注（P <0.0001;卡方检验）。干预前进行了214次（55％）的认可机会认可，之后进行了57次（30％）的认可（P <0.0001;卡方检验）。结论干预增加了提供病房药房服务所需的总时间，并改变了所开展活动的类型。与医务人员的联系时间增加了。与患者相处的时间没有明显变化。干预后需要较少的药房认可，但实际比例较低。这些发现对类似系统的设计，引入和使用具有重要意义。

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