Medical incidents have been collected, analyzed and built up preventive measures by each medical institution for a long time. For powdered medication, there is the problem that it is difficult to tell at a glance the quantity of the active ingredient in the medication that has been dispensed and the quantities that have been mixed together. Therefore, special prevention measures are considered essential. In this study, we examined the work content of pharmacists' powdered medication dispensing, using an eye-tracking technology of measuring a human eye movement, and studied on factors that affect medical incident. Participants were five pharmacists with 8 to 26 years of working experience (expert), and five pharmacists with less than one year of working experience (newcomer). Gaze measurement experiments were implemented for powdered medication dispensing during regular work activity. The gaze measurement equipment used was Tobii Pro Glasses 2. Based on the results of the eye tracking, newcomer had a longer dispensing time than expert for all powdered medication dispensing. In particular, it was suggested that there is a close relationship to "years of experience" and "weighing and mixing skills." Experts did unwasted and efficient movements, when preparing the dispensing apparatus, taking medications from the shelves, and scanning the barcode in the powders dispensing checking system. These movements led to shorter working time in experts. In contrast, newcomer had individual differences at the dispensing. Even with the same pharmacist, the work progression differed depending upon the prescription. Therefore, it is thought that the factor of common error was inadequate check and overlooked. The state that it's messy on the workplace is also considered highly likely to cause dispensing mistakes. At the weighing, expert started weighing after the inspection of the prescription and checking weighed amount. However, certain newcomer dispensed to depend on the powders dispensing checking system only for the weighing process
We developed a total management system of hospital preparations to manage the preparation of raw materials, hospital preparations and the use of patient information for hospital preparations generally in Aichi Medical University Hospital and built a safe means of preparing the hospital preparations and an appropriate use regime. We used an object-relational database management system. The main functions are the management of raw materials of hospital preparations and hospital preparation stock, checking preparations and management of information of hospital preparations. In administration of hospital preparation stock, when raw materials of hospital preparations are stocked, we record in the system the batch number of raw materials for hospital preparations to secure their traceability. When the system is started up, the information of hospital preparations is shown on the display before a deadline that makes possible the administration of all hospital preparations in terms of validity in the hospital. In preparing an evaluation, we made a preparation master of hospital preparations and then raw materials of hospital preparations were authenticated and the weight checked to make it possible to prepare hospital preparations by only a pharmacist. It was effective in reducing the working hours for preparation and recording information. Moreover, the information of patient's administration ensures that informed consent is obtained where necessary and reports on clinical use results are collected. The clinical use results report recorded in the system make it possible to administer hospital preparations validly, safely, and with awareness of the side effects.
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