智能化药品闭环管理在药品管理流程优化的应用体会
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摘要
目的:基于医疗物联网技术的智能终端设备在医院药品供应及分发流转中的应用,实现药品高效及精细化的闭环管理。方法:采用智能化药柜终端和智能物流机器人,对麻醉科和重症监护室(ICU)临床用药模式、药剂科药品分发管理模式进行流程再造和优化,打通医院信息系统(HIS)和智能药品管理系统间的信息交互,使物品流和数据流得到统一。结果:智能药柜的使用,使药品管理时间由平均5.92 h/d降为3.97 h/d,术中用药准备时间由平均20.5 min/台降为8 min/台,临时医嘱药品平均调剂时间由24.5 min下降到5.82 min,其差异有统计学意义(t=5.345,P<0.05)。比较智能药柜上线前3个月(2016年7-9月)与同期上线后3个月(2017年7-9月),医院麻醉科、ICU和心脏监护室(CCU)临时医嘱平均退药次数明显减少,其差异有统计学意义(t=3.725,t=3.804,t=3.481;P<0.05)。结论:智能化药品闭环管理通过对药品使用流程再造实现药品院内流转,减少人工环节,提高药品管理效率,提升患者满意度。
Objective: To apply intelligent terminal equipment based on medical internet of things technique in the supply and distribution of drugs of hospitals so as to achieve efficient and fine closed-loop management for drug. Methods:Intelligent medicine cabinet terminals and intelligent logistics robots were used in anesthesia department and intensive care unit(ICU) to reengineer and optimize the processes of clinical medication mode and drug distribution management mode in pharmacy department, and to achieve information exchange between hospital information system(HIS) and intelligent drug management system, and to finally unify goods flow and data flow. Results: The use of intelligent medicine cabinet reduced the average time of clinical drug management from 5.92 h/d to 3.97 h/d, the preparation time of intraoperative medication from 20.5 min/desk to 8 min/desk, and the average dispensing time of temporary prescription drugs from 24.5 min to 5.82 min. The difference of average dispensing time of temporary prescription drugs between pre and post use was significant(t=5.345, P<0.01). The first three months(July-September 2016) of the intelligent medicine cabinet on-line were compared with the last three months(July-September 2017) of the same period on-line, the results indicated that the average times of drug withdrawal of temporary prescription in anesthesia department, ICU and CCU decreased significantly(t=3.725,t=3.804, t=3.481, P<0.05). Conclusion: Intelligent drug closed-loop management realizes drug circulation in hospital through reengineers management and use process of drug, and reduces manual links, and increases drug management efficiency, and improves satisfaction of patients.
Objective: To apply intelligent terminal equipment based on medical internet of things technique in the supply and distribution of drugs of hospitals so as to achieve efficient and fine closed-loop management for drug. Methods:Intelligent medicine cabinet terminals and intelligent logistics robots were used in anesthesia department and intensive care unit(ICU) to reengineer and optimize the processes of clinical medication mode and drug distribution management mode in pharmacy department, and to achieve information exchange between hospital information system(HIS) and intelligent drug management system, and to finally unify goods flow and data flow. Results: The use of intelligent medicine cabinet reduced the average time of clinical drug management from 5.92 h/d to 3.97 h/d, the preparation time of intraoperative medication from 20.5 min/desk to 8 min/desk, and the average dispensing time of temporary prescription drugs from 24.5 min to 5.82 min. The difference of average dispensing time of temporary prescription drugs between pre and post use was significant(t=5.345, P<0.01). The first three months(July-September 2016) of the intelligent medicine cabinet on-line were compared with the last three months(July-September 2017) of the same period on-line, the results indicated that the average times of drug withdrawal of temporary prescription in anesthesia department, ICU and CCU decreased significantly(t=3.725,t=3.804, t=3.481, P<0.05). Conclusion: Intelligent drug closed-loop management realizes drug circulation in hospital through reengineers management and use process of drug, and reduces manual links, and increases drug management efficiency, and improves satisfaction of patients.
引文
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[2]陈晓莉,张瑞,楚尧娟,等.智能麻醉药品管理系统在我院麻醉科的应用实践及体会[J].中国药房,2015,26(16):2247-2250.
[3]Hahn JO,Dumont GA,Ansermino JM.Closedloop anesthetic drug concentration estimation using clinical-effect feedback[J].IEEE Trans Biomed Eng,2011,58(1):3-6.
[4]王瑞君,朱晓虹,王咏梅,等.智能毒麻药管理柜在我院住院西药房的应用评价[J].中国药房,2015,26(16):2241-2243.
[5]唐慧,张蕾,姚刚,等.运用摆药机实现口服药闭环医嘱管理[J].中国医院药学杂志,2014,34(11):943-946.
[6]Correa S,Choi KY,Dreaden EC,et al.Highly scalable,closed-loop synthesis of drug-loaded,layer-by-layer nanoparticles[J].Adv Funct Mater,2016,26(7):991-1003.
[7]王海娇,王欣然,王硕,等.闭环式智能化ICU病房基数药品管理系统的开发与应用[J].中国卫生质量管理,2016,23(1):76-78.
[8]冯焕村,韦美丹.运用精益管理优化中心药房工作流程[J].实用医院临床杂志,2014,11(2):150-152.
[9]李建平,施世彪.住院药房管理流程的优化和改进[J].中国医疗设备,2015,30(12):143-145.
[10]朱翠华,于建立,王卫平,等.病区使用自动化智能药柜管理药品模式的实践与体会[J].中国药房,2017,28(22):3102-3105.
[11]石磊,何健,耿子平.智能药柜管理系统的设计与应用[J].医疗卫生装备,2016,37(7):67-69.
[12]沈国荣,王永,张倢,等.我院中心药房麻精药品智能化管理系统的开发与应用[J].中国药房,2018,29(9):1158-1161.
[13]姜柏林,何苗,冯艺.智能化管理模式优化临床麻醉药品的管理[J].中国疼痛医学杂志,2016,22(8):612-615.
[14]戴春雷.手术室麻醉药品的规范化管理[J].医药导报,2013,32(3):413-414.
[15]何健,石磊,高明,等.一种医院检验试剂监管系统的设计[J].中国医学装备,2018,15(6):119-123.
[16]Pant SM,Mukonoweshuro A,Desai B,et al.Design,synthesis and testing of potent,selective hepsin inhibitors via application of an automated closed-loop optimization platform[J].J Med Chem,2018,61(10):4335-4347.