智慧醫療臨床應用－南部某醫學中心導入智慧藥櫃推行經驗分享

由於科技發展，各種相關自動儀器設備也陸續導入醫療環境藉以簡化工作流程，透過網路資訊及各項科技產品的研發，臨床亦導入智慧醫療的運用，包括從預防醫學到臨床科技輔助與照護概念均廣泛運用於健康促進相關領域，而智慧藥櫃（Automated Dispensing Cabinet, ADC）的推行是其中之一項設備。傳統藥物傳送過程可能會受到某些干擾而延遲，若遇到病人危急或緊急取用，難免會使臨床照護備感壓力。為了使醫囑可以讓藥師立即審核與臨床即時取得藥物，院方透過工務、資訊、藥劑、護理團隊之專業討論及巧思規劃，分析臨床常規給藥作業模式，結合藥師調劑及醫囑並連結資訊系統，進行智慧藥櫃建置及推展。此智慧藥櫃於2020年1-12月規劃，逐一推行並改變臨床藥物傳送及取藥模式。分析給藥異常發生率從實施前0.12%（2020年4-9月）、實施後0.10%（2020年10月-2021年3月）至效果維持0.08%（2021年4-9月）。期待此推行智慧藥櫃之過程及經驗，可以提供各健康照護機構引進相關智慧醫療臨床應用之參考。

關鍵字

智慧藥櫃；健康促進；加護病房；智慧醫療

並列摘要

Due to the development of science and technology, various related automatic instruments and equipment have also been introduced into the medical environment to simplify the work process. Through the research and development of network information and various technological products, the clinical application of smart medical introduced. The concepts used in health promotion related fields, including from preventive medicine to clinical care technology assistance, and the smart medicine cabinet (Automated Dispensing Cabinet, ADC) is one of the devices. The delivery of traditional medicines may be delayed due to some interference. If the patient was in an emergency situation, may be feel pressured of the nursing process. In order to allow the doctor's order to be reviewed by the pharmacist immediately and clinically get the medicine in time, through professional teams to discussion and ingenious suggestions from the works, information, pharmacy, and nursing, to analysis the clinical routine drug delivery mode, combine the pharmacist's prescription and doctor's orders, and link to the information system to build and implementation the Automated Dispensing Cabinet. The implementation process of the Automated Dispensing Cabinet combines the planning one by one from January to December 2020, to change the mode of clinical drug delivery and get medication. The incidence of abnormal administration was analyzed from 0.13% before implementation (April-September 2020), 0.10% after implementation (October 2020-March 2021) to 0.08% maintains the effect (April-September 2021). I look forward to the process and experience of the implementation of the smart medicine, which can provide for various health care institutions to introduce relevant smart medicine clinical applications.

並列關鍵字

Automated Dispensing Cabinet (ADC) ； Health Promotion ； Intensive Care Unit ； smart medicine ； experience

參考文獻

王偉仲、何智凡（2020）．醫學影像分析中的人工智慧、擴增智慧與人類智慧．台灣醫學，24(1)，43-49。https://doi.org/10.6320/fjm.202001_24(1).0004.

林書弘、陳牧言（2019）．人工智慧技術於智慧醫療之理論探討與實務應用．護理雜誌，66(2)，7-13。https://doi.org/10.6224/jn.201904_66(2).02

陳學源、湯念湖（2019）．由「自動化調劑藥櫃」看未來臺灣住院病人給藥模式．臺灣臨床藥學雜誌，27(3)，171-179。 https://doi.org/10.6168/fjcp.201907_27(3).0001

黃織芬（2021）．新智慧科技在藥事作業的應用．台灣醫學，25(5)，613-620。 https://doi.org/10.6320/fjm.202109_25(5).0006

劉兆鴻、郭獻明、吳明芬、劉文雄（2019）．應用智慧藥櫃於外科加護病房首日藥量管理之效益評估．臺灣臨床藥學雜誌，27(2)，122-134。https://doi.org/10.6168/fjcp.201904_27(2).0005

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