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          前置智能化精准加药及核对系统在全自动单剂量分包中的应用
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          张润赞 ,卢钧煜 ,洪 蕾 ,李留成 ,应 杰 (1.浙江大学医学院附属邵逸夫医院药学部,杭州 310016;2.浙
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          江大学医学院附属邵逸夫医院门诊部,杭州 310016)
          中图分类号  R952      文献标志码  A      文章编号  1001-0408(2025)17-2170-06
          DOI  10.6039/j.issn.1001-0408.2025.17.15


          摘   要  目的  创新性地应用前置智能化精准加药及核对系统(后文简称“系统”),为住院药房高水平“智慧化”改造提供参考。
          方法  分析全自动药品单剂量分包机(ATC)+智能半片台(ITDT)+全自动药品核对机(MDM)三串联调剂模式存在的不足。应用
          系统并采用扫码核对方式优化预加药管理、整片药品外摆流程和ATC临时加药管理;比较系统应用前后各8个月内的加药时间和
          人力成本、分包差错等情况。结果  三串联调剂模式在人工加药环节对差错风险的规避能力较弱,在核对环节也存在误差。通过
          创新性地应用该系统,升级了预加药管理,优化了整片药品外摆流程,完善了ATC临时加药管理。与系统应用前比较,系统应用
          后平均每个药品的预加药时间、整片药品外摆时间和ATC临时加药时间均显著缩短(P<0.001),且所需药师由原来的2名减少至
          1名;ATC差错率由0.220‰下降至0.029‰(P<0.001),其中药师人为因素(预加药品错误、ITDT加药错误和ATC临时加药错误)
          导致的差错率由0.116‰下降至0.001‰(P<0.001),机器原因导致的差错率由0.096‰下降至0.023‰(P<0.001)。结论  该创新
          融合模式有效提升了住院药房工作效率及质量,加强了药品效期及库存等精细化管理,节省了时间和人力成本,提高了药品分包
          的准确性,切实保障了患者的用药安全。
          关键词  住院药房;前置智能化加药;精准加药;系统核对

          Application of a pre-intelligent precision dosing and verification system in automatic single-dose packaging
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          ZHANG Runzan ,LU Junyu ,HONG Lei ,LI Liucheng ,YING Jie(1.  Dept.  of  Pharmacy,  Sir  Run  Run  Shaw
          Hospital,  School  of  Medicine,  Zhejiang  University,  Hangzhou  310016,  China;2.  Dept.  of  Outpatient,  Sir  Run
          Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China)
          ABSTRACT    OBJECTIVE To innovatively apply the pre-intelligent precision dosing and verification system (hereinafter referred
          to  as “the  system”),  and  to  provide  a  reference  for  the  high-level “intelligent”  transformation  of  inpatient  pharmacy.  METHODS
          The  limitations  of  the  triple-serial  dispensing  mode,  which  comprised  the  automatic  medicine  packaging  machine (ATC),
          intelligent tablet dispensing table (ITDT) and medication detection machine (MDM), were analyzed. The application of the system
          and  the  adoption  of  the  barcode  scanning  verification  method  optimized  the  pre-dosing  management,  whole-tablet  drug  dispensing
          process  and  ATC  temporary  dosing  management.  The  comparative  analysis  was  conducted  to  assess  dosing  time,  labor  cost  and
          packaging  error  of  the  eight-month  period,  before  and  after  the  system  application.  RESULTS  The  triple-serial  dispensing  mode
          had  a  weak  ability  to  avoid  error  risks  in  the  manual  dosing  stage,  and  also  had  errors  in  the  verification  stage.  Through  the
          innovative  application  system,  the  pre-dosing  management  had  been  upgraded,  the  whole-tablet  drug  dispensing  process  had  been
          optimized, and the ATC temporary dosing management had been improved. The average time required for each drug for pre-dosing,
          whole-tablet  drug  dispensing  and ATC  temporary  dosing  was  significantly  shortened  after  the  application  of  the  system,  compared
          with  before  the  application  of  the  system (P<0.001). The  number  of  pharmacists  was  reduced  from  two  to  one. The  error  rate  of
          ATC  decreased  significantly  from  0.220‰  to  0.029‰ (P<0.001).  Specifically,  the  rate  of  pharmacist-related  errors (pre-dosing
          error, ITDT dosing error, and ATC temporary dosing error) decreased from 0.116‰ to 0.001‰ (P<0.001), and machine-related
          errors  decreased  from  0.096‰  to  0.023‰ (P<0.001).  CONCLUSIONS  This  innovative  integration  mode  greatly  improves  the
          working efficiency and quality of inpatient pharmacy. It enhances refined management of drug expiration and inventory, saves time
                                                              and  labor  costs,  improves  the  accuracy  of  drug  dispensing,
              Δ 基金项目 浙江省自然科学基金项目(No.LYY19H280006)
             * 第一作者 药 师 ,硕 士 。 研 究 方 向 :医 院 药 学 。 E-mail:     and ensures patient medication safety.
          zhangrunzan@zju.edu.cn                              KEYWORDS    inpatient  pharmacy;  pre-intelligent  dosing;
              #  通信作者 副 主 任 药 师 。 研 究 方 向 :医 院 药 学 。 E-mail:  precision dosing; systematic verification
          593462458@qq.com


          · 2170 ·    China Pharmacy  2025 Vol. 36  No. 17                            中国药房  2025年第36卷第17期
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