社團法人臺灣臨床藥學會

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【綜合評述】由「自動化調劑藥櫃」看未來臺灣住院病人給藥模式
From Automatic Dispensing Cabinet to Future Mode of Medicine Administration for Hospitalized Patients in Taiwan
單一劑量作業,自動化調劑藥櫃,給藥流程、Unit-Dose Distribution System, Automated Dispensing Cabinets, Administration Process
陳學源Shyue-Yuan Chen1 、湯念湖Ni-Hu Tang2,*
1衛生福利部彰化醫院藥劑科 、2臺中榮民總醫院藥學部
1980 年單一劑量作業制度引進臺灣,現在幾乎成為全臺各醫院住院病人採用的給藥模式,雖然單一劑量方式給藥既方便又經濟,且可以減少給藥錯誤,但是單一劑量作業制度仍不完美。國外採「自動化調劑藥櫃」 (automated dispensing cabinets, ADCs) 來改進單一劑量作業的缺點;ADCs 它是由電腦控制藥品儲存,可以就近提供藥品並追蹤護理人員給藥記錄。成功設置ADCs 需要醫院管理者、護理人員及藥師之間密切合作。管理者必須考量自身醫院之規模、經費的負擔、空間需求與人力成本的變化。護理人員需要考慮ADCs 擺放,定期舉辦ADCs 操作訓練與制訂相關之標準作業流程。藥師需要考慮資訊系統整合,藥品補充及可能需額外增加人力與空間設備。ADCs 設置優化住院病人給藥流程,節省往返藥局及等待藥品的時間,使給藥流程更加順暢與安全,護理人員更方便取得藥品,藥師有更多時間從事臨床照護;對於醫院、護理人員、藥師與全民健康是一大福音。

The unit-dose distribution system was introduced in Taiwan in 1980, which has become the mainstream method widely used in almost all hospitals in Taiwan to provide medicines for inpatients. Although this system is both convenient and economical and can also reduce dosing errors, it is still not perfect. Outside Taiwan, automated dispensing cabinets (ADCs) are used to improve the limitations of the unitdose distribution system. The ADC is a drug storage cabinet controlled by a computer and can provide medicines nearby and track nurses’ administration records. The successful setting up of ADCs requires close cooperation between hospital managers, nurses, and pharmacists. Managers must consider the size of their hospital, the financial constraints, the space requirements, and the changes in labor costs. Nurses should consider the ADC display, regularly organize the ADC operation training program, and develop related standard operating procedures. Pharmacists must consider the integration of computer information system and drug replenishment and may require additional manpower and space equipment. Automated mediator setting optimizes the inpatient dosing process, saves time back and forth to pharmacy and waiting time for medicines, makes the dosing process smoother and safer, and makes it easier for nurses to obtain medicines. Pharmacists would have more time to engage in clinical care. Thus, ADCs can be considered as a big boon for the hospital, nursing staff, pharmacists, and public health.
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