An automated dispensing system for improving medication timing in the emergency department

查看全文 作　　者：Michael [1]J.Ward;Jeremy [1]S.Boyd;Nicole [2]J.Harger;John [1]M.Deledda;Carol [1]L.Smith;Susan [3]M.Walker;Jeffrey [3]D.Hice;Kimberly [1]W.Hart;Christopher [1]J.Lindsell;Stewart [1]W.Wright

机构地区：[1]Department of Emergency Medicine,University of Cincinnati;[2]Pharmacy Division,University of Cincinnati;[3]Air Care and Mobile Care,University Hospital,University of Cincinnati

出　　处：《World Journal of Emergency Medicine》索引2012年第3卷第2期,共6页

基　　金：supported by a Resident Research Grant from the University of Cincinnati Department of Emergency Medicine;by a Research Fellowship Award from the Emergency Medicine Foundation;by an Institutional Clinicaland Translational Science Award,NIH/NCRR Grant Number 5UL1RR026314-02 摘　　要：BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been studied.Since vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED.The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness.METHODS:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 000.Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in 2009.The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness.RESULTS:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the study.Before intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness. 关键词：Automatic dispensing system PHARMACEUTICAL Process improvement Efficiency

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An automated dispensing system for improving medication timing in the emergency department

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