Upgrading a Pharmaceutical Information System for Preparation of Parenteral Admixtures for Ambulant Chemotherapy in a Hospital Pharmacy Using End-user Prototype Model, and Comprehensive Evaluation of Upgraded System

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  • Ikeda Kenji
    Department of Pharmacy, Osaka University Hospital
  • Takegami Manabu
    Department of Pharmacy, Osaka University Hospital
  • Tajima Shigetoshi
    Department of Pharmacy, Osaka University Hospital
  • Miyawaki Koji
    Department of Pharmacy, Osaka University Hospital
  • Higashi Makiko
    Department of Pharmacy, Osaka University Hospital
  • Yagi Yuriko
    Department of Clinical Pharmaceuticals, Graduate School of Pharmaceutical Sciences, Osaka University
  • Kamekawa Hideki
    Toshiba Solutions Corporation
  • Kurokawa Nobuo
    Department of Pharmacy, Osaka University Hospital Department of Clinical Pharmaceuticals, Graduate School of Pharmaceutical Sciences, Osaka University

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  • 外来がん化学療法部門システムの追加導入と混合調製業務に寄与する因子の多変量解析

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Pharmaceutical support systems for anti-neoplastic drug preparation for chemotherapy in hospital information systems are in need of improvement. With this in mind we developed a new support system in collaboration with system engineers (SEs) in January 2005. In the presentation of our requirements for the support system to the SEs, the most important part of the development process, we proposed a development model based on an end-user prototype system. The model comprised a five-step design and development of the prototype system through end-user computing, evaluation of the prototype system through actual use, the introduction of a step to determine the exact task requirements, detailed discussions with the SEs, and installation. Among the functions of the prototype system were support functions for the input of prescriptions, inventory management and task data assessment and a print-out function for record sheets. This model produced excellent results for the upgrade whose express purpose was the introduction of an end-user computing step. Furthermore, to evaluate the preparation support system, time-determinative factors involved in the preparation were analyzed and compared using data collected in November 2004 and March 2005. In the evaluation, two pharmacists dispensed a total of 791 and 1003 admixtures for 341 and 426 injection prescriptions, respectively, and the average preparation times were 18.15 and 15.43 minutes/prescription, respectively. Multiple regression analysis revealed several time-determinative factors with correlation coefficients of 0.803 and 0.668. The significant time-determinative factors were the number of vials, ampoules, and bottles for admixtures and the properties of drugs dispensed. The new system has resulted in improved patient safety and operational efficiency.

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