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

作     者：Michael J.Ward Jeremy S.Boyd Nicole J.Harger John M.Deledda Carol L.Smith Susan M.Walker Jeffrey D.Hice Kimberly W.Hart Christopher J.Lindsell Stewart W.Wright 

作者机构：Department of Emergency MedicineUniversity of Cincinnati Pharmacy DivisionUniversity of Cincinnati Air Care and Mobile CareUniversity HospitalUniversity of Cincinnati 

出 版 物：《World Journal of Emergency Medicine》 (世界急诊医学杂志（英文）)

年 卷 期：2012年第3卷第2期

页      面：102-107页

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 08[工学] 

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 

主　　题：Automatic dispensing system Pharmaceutical Process improvement Efficiency 

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 *** 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 *** study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing ***: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 *** subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in *** primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing ***:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the *** 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.