医療安全におけるITの重要性〜特に5つの"Right"について

Abstract

Electrical verification systems with Bar code and RFID at point of care have been gradually accepted by hospitals as an important solution for ensuring accuracy of medical activities and patient safety. 5 rights of medication administration including right patient, right drug, right dose, right route and right time is quite essential component for patient safety and bar code administration system can contribute to assure 5 rights. The purpose of this study is to investigate effects of electrical verification systems for patient safety that are based on redefined concept of 5 rights with IT environment. We reviewed literatures to clarify information to be verified before drug administration and construct framework to understand medication safety with the concept of 5 rights. Following the study, log data captured by hospital information system named Point of Act System in International Medical Center of Japan was analyzed for understanding real implementation of the system for ensuring 5 rights. According to the literature, 5 rights is one of the main standards for safe medication. However, the definitions of 5 rights reflected environmental change of administration with IT system. Verification of drugs means not only verify name of drug but also verify right preparation and adverse drug event under IT environment. Most of systems introduced in hospitals constructed not to ensure 5 rights but to identify patients, drugs and nurses. In contrast to these system, Point of Act System operated in International Medical Center of Japan have been ensuring 5 rights of medication and log data captured by PDA showed its accuracy and reliability. Discussion on bar code medication administration system didn’t realize difference of credibility and safety among systems. Point of Act System was designed to ensure 5 rights with single item management through serialized number and assure correctness of information with its architecture. To emphasize effects of bar code medication administration system, it is important to clarify the difference.

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