規劃分艙分流機制以降低COVID-19導致藥事服務中斷之風險

Planning Isolation and Triage Mechanism to Reduce the Interrupted Risk of Pharmaceutical Services During COVID-19 Epidemic

呂英豪(Ying-Hao Lu) ； 郭震群(Chen-Chun Kuo) ； 王雅玲(Ya-Ling Wang) ； 李俐瑤(Li-Yao Lee) ； 沈玫秋(Mei-Chiu Shen) ； 王嘉宏(Jia-Hong Wang) ； 許郁笙(Yu-Sheng Hsu) ； 李純真(Chun-Chen Lee) ； 洪靖慈(Ching-Tzu Hung)

《醫療資訊雜誌》 30卷3期 (2021/09) Pp. 13-24+26

摘要

台灣的醫學中心多採「中心藥局」模式執行各項藥事作業與人力管理。藥局為全院各單位24小時不中斷之藥品供應中心，所以如何在面對COVID-19疫情衝擊時讓藥局能持續運作為醫學中心防疫工作之重要議題。本研究希望藉由規劃各項藥事作業於不同疫情等級之「分艙分流」作法，期望若發生院內感染時可有效降低藥局交叉或群聚感染發生，並保有持續運作的藥事服務能量。各項藥事作業「分艙分流」之規劃以COVID-19疫情等級、門診停診情境、門診領藥量與住院床數作為主要評估依據。利用5W（人、事、時、地、物）層別法進行評估，並盤點各工作地點分佈狀況與疫情風險等級。整體性規劃後，在低度疫情等級（A2）時，急診藥局採超前部署，固定人員與地點之分艙模式上班，其他單位則在中度疫情等級（B）時才啟動分艙模式，重度疫情等級（C）時再加上分組模式上班。經感染管控中心評估本醫院化療調配室屬C級疫情等級之隔離區（高風險區），急診藥局屬中風險區，門診發藥窗口、藥物諮詢室、與慢性病連續處方箋戶外領藥區等屬中低風險區，然後依照風險區等級高低規劃不同因應管理措施。其中設置慢性病連續處方箋戶外領藥區，為讓單純返院領取慢箋之民眾分流於院外，減少入院感染機會與降低醫院群聚感染的風險。另外，評估於疫情嚴重時暫停非急迫性之藥事服務並且規劃人員與環境之清潔規範。本研究確實有效運用「分艙分流」風險降低之管理機制，讓各項藥事作業進行適當之人力分配與工作規劃。本研究亦可作為其他醫學中心面臨COVID-19或其他新興傳染病時，藥事作業如何「分艙分流」規劃之參考。

關鍵字

COVID-19 ； 新型冠狀病毒 ； 藥事作業 ； 分艙分流 ； 風險降低

並列摘要

Taiwan medical centers mainly use ＂Central Pharmacy＂ to carry out pharmaceutical operations and human resources management. The pharmacy is a 24-hour medication supply center for all units in the Hospital. Therefore, how to make the pharmacy run continuously in the potential impact of COVID-19 pandemic is an important issue in the epidemic prevention of the medical center. The purpose of this study is to design to reduce the incidence of cross or cluster infection in the event of nosocomial infection and to maintain the continuous operation of pharmaceutical service. The planning of ＂isolation and triage＂ of pharmaceutical operations is based on the epidemic level of COVID-19, the closing situation of outpatient service, the number of outpatients receiving medicine service and the number of inpatient beds. After the overall planning, in the case of the low epidemic level (level A1), the emergency pharmacy took advance deployment, and fixed personnel was assigned to work in fixed location in the isolation, while other units started the isolation mode in the case of the moderate epidemic level (level B). Grouping mode was added for the severe epidemic level (level C). Different management measures should be planned according to the different level of risk area evaluated by the infection control center. In this study, the risk reduction management mechanism of ＂isolation and triage＂ was effectively used to make proper manpower allocation and work planning for all pharmaceutical service in Hospital.

並列關鍵字

COVID-19 ； Coronavirus ； Pharmaceutical service ； Isolation and triage ； Risk reduction