大型综合门诊药房自动化配药系统模式的建立与优化

摘要

目的:为大型综合门诊药房自动化配药系统工作模式的建立提供参考.方法:通过介绍我院门诊药房自动化配药系统的建立与优化的实践情况,比较优化前后相关调配指标的变化,探讨提高自动化配药系统工作效率的主要措施.结果:通过设置机内存放药品品种、药品占用轨道数及拆零药品因子数并定期调整,设计系统自动分配处方至"即配"和"预配"调配窗口的调配操作模式,建立操作规范及采取管理细化等措施,我院门诊药房建立了处方调配量可达12000张/d以上的自动化配药系统,并优化了相应的工作模式.与优化前比较,优化后在工作人员总数不变的情况下,自动化配药系统中主机、辅机和智能柜品种数均增加,"即配"窗口数增加,"预配"窗口数减少;在高峰时段处方总数增加的情况下,自动化调配处方占比升高(由41.18%升至48.32%),患者平均候药时间缩短(由5.63 min缩短至5.18 min),向机器内补药差错数和调配内差率(由0.48%降至0.44%)均降低(P<0.05).结论:我院建立的自动化配药系统及模式可以满足大型综合门诊药房处方调配工作需求;不断优化自动化配药系统可提高其工作效率.%OBJECTIVE:To provide reference for the establishment of work mode of automatic dispensing system in large-scale integrated pharmacy. METHODS:Introducing the establishment and optimization situation of the automatic pharmacy dispensing system in the outpatient pharmacy of our hospital,changes of related deployment indexes before and after optimization were compared,and the main measures for improving the work efficiency of automatic dispensing system were explored. RE-SULTS:Based on setting and regularly adjusting stored drug varieties,numbers of occupied tracks and unbundled drug factors,de-signing deployment operation mode that the system automatically dispensing preparations to immediate-dispensing and pre-dispens-ing windows,establishing operational specifications and management refinement,the outpatient pharmacy had established automat-ic dispensing system with prescription deployment number more than 12000 pieces/d and optimized work mode. Compared with be-fore optimization,host,auxiliary and smart cabinet varieties were increased in the case of the same number of total staff,immedi-ate-dispensing windows were increased and pre-dispensing windows were decreased. Proportion of full-automatically-dispensed pre-scriptions was increased (up from 41.18% to 48.32%) in the case of total prescription increasing in peak hours,and numbers of hourly prescription deployment were increased in both immediate-dispensing and pre-dispensing windows. Average time to wait for medicine of patients was shortened(down from 5.63 min to 5.18 min),supplemental medicine error and inner errors rate of deploy-ment (down from 0.48% to 0.44%) were decreased (P<0.05). CONCLUSIONS:The established automatic dispensing system mode can meet the needs of prescription deployment in large-scale integrated outpatient pharmacy,and improve the work efficiency by continually optimization.