Development and implementation of autoverification standardization in the adult and pediatric emergency department.

IF 2.1 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Savanna Scott, Umbreen Murtaza, Sara Choi, Ian Watt, Juliana Chamless, Rosemary Duncan, Meghan Rowcliffe, Jacob Smith, Emily Pherson
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引用次数: 0

Abstract

Purpose: This project utilized the guidance of the American Society of Health-System Pharmacists (ASHP) autoverification toolkit to refine our health system's approach to autoverification and contribute to the literature regarding appropriate use of autoverification technology in a pediatric and adult emergency department (ED).

Summary: This single-center quality improvement study was conducted in an academic medical center ED that has 33 pediatric beds and 77 adult beds. A team consisting of clinical pharmacy specialists in emergency medicine, medication safety and informatics personnel, operational managers, and pharmacy leadership was identified to develop and implement autoverification best practices in the ED utilizing practices outlined within the ASHP autoverification toolkit. Before implementation of best practices, defined as the "preoptimization" state, autoverification took place for most medications available in the automated dispensing cabinets (ADCs). By anchoring the autoverification rule on ADC inventory, it was challenging to optimize both inventory practices and autoverification best practices. This project focused on redesigning the autoverification rules in the electronic health record, defined as the "postoptimization" state. In the postoptimization state, autoverification in the ED was updated to better align with regulatory standards. Autoverification metrics and the percentage of orders that autoverified vs required pharmacist verification were analyzed in the preoptimization and postoptimization states.

Conclusion: This project utilized the guidance from ASHP's autoverification toolkit to refine our health system's approach to autoverification. High-alert medications (eg, insulin, extended-release opioids, digoxin) were taken off autoverification following implementation. Optimization of autoverification rules allows more orders for high-alert medications to be reviewed by a pharmacist.

在成人和儿科急诊室制定和实施自动化标准化。
免责声明:为了加快文章的出版速度,AJHP在接受稿件后会尽快在网上发布。被录用的稿件已经过同行评审和校对,但在进行技术格式化和作者校对之前会在网上发布。这些稿件并非最终记录版本,稍后将由最终文章(按 AJHP 风格排版并由作者校对)取代。目的:该项目利用美国卫生系统药剂师协会(ASHP)自动转归工具包的指导,完善了我们医疗系统的自动转归方法,并为有关在儿科和成人急诊科(ED)中适当使用自动转归技术的文献做出了贡献。研究小组由急诊科临床药学专家、用药安全和信息学人员、运营经理和药学领导组成,利用 ASHP 自动转换工具包中概述的方法,在急诊科开发并实施自动转换最佳实践。在实施最佳实践(被定义为 "优化前 "状态)之前,自动配药柜 (ADC) 中的大多数药物都进行了自动转换。由于自动配药系统的自动配药规则以自动配药柜的库存为基础,因此要同时优化库存实践和自动配药最佳实践非常困难。本项目的重点是重新设计电子病历中的自动配药规则,将其定义为 "优化后 "状态。在 "优化后 "状态下,对急诊室的自动交接进行了更新,以便更好地与监管标准保持一致。分析了优化前和优化后状态下的自动核查指标以及自动核查与需要药剂师核查的订单百分比:该项目利用 ASHP 自动核销工具包中的指导,完善了我们医疗系统的自动核销方法。高警戒药物(如胰岛素、缓释阿片类药物、地高辛)在实施自动转归后被取消。自动核销规则的优化使药剂师能够审核更多的高警戒药物订单。
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来源期刊
CiteScore
2.90
自引率
18.50%
发文量
341
审稿时长
3-8 weeks
期刊介绍: The American Journal of Health-System Pharmacy (AJHP) is the official publication of the American Society of Health-System Pharmacists (ASHP). It publishes peer-reviewed scientific papers on contemporary drug therapy and pharmacy practice innovations in hospitals and health systems. With a circulation of more than 43,000, AJHP is the most widely recognized and respected clinical pharmacy journal in the world.
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