JP6890851B2 - Dispensing audit method, dispensing audit system and dispensing audit program - Google Patents

Description

The present invention relates to a dispensing audit method, a dispensing audit system and a dispensing audit program.

At dispensing pharmacies and the like, pharmacists dispense patients based on prescriptions. At that time, it is confirmed (audited) whether the dispensed medicine was dispensed according to the prescription. Then, if there is no problem in the audit, the dispensed medicine is delivered after the patient is instructed to take the medicine.
In such dispensing, there has been a possibility that a dispensing incident (incident) such as an incorrect pick-up or an incorrect quantity may occur when arranging drugs. On the other hand, a system for preventing the occurrence of an incident has been developed so far.

FIG. 3 is a diagram showing a flowchart showing an example of a conventional dispensing audit method.
In the flow of the dispensing audit method of FIG. 3, first, the prescription submitted by the patient is accepted (step S011). Regarding the contents of the prescription, check the prescribed items and others (prescription audit).
Next, the contents of the received prescription (prescription data) are input to the receipt computer (receipt computer) to acquire the prescription data (step S012).
Next, the pharmacist prepares and dispenses the medicines based on the prescription data input to the receipt computer (step S013). Each drug has its own barcode. Read each barcode and read the dispensing data into the computer.
Next, the prescription data acquired in step S012 and the dispensing data read in step S013 are collated on the auditing personal computer to perform a final audit (step S014). If the results of the collation match, the prescribed drug is delivered to the patient (step S015).

As such a conventional dispensing audit method, for example, in Patent Document 1, prescription data, picking result data, and dispensing result data are collected on an auditing personal computer and displayed on the display, and an auditor in light of the display. A dispensing audit system has been proposed that allows the company to audit dispensing.

For example, in Patent Document 2, the pharmacist performs prescription-based dispensing in parallel with the operation of inputting prescription data by the operator and the operation of the personal computer, and collates the input picking data with the prescription data on the personal computer. A dispensing pharmacy business support system equipped with this has been proposed.
In the dispensing pharmacy business support system described in Patent Document 2, when dispensing tablets or capsules, the picking data is obtained from the IC tag or the like attached to the drug picked by the pharmacist while looking at the prescription, through the pharmacist's hand. It contains the read information. When dispensing powder or liquid medicine, the type information of the powder or liquid medicine is read from the IC tag or the like attached to the powder or liquid medicine container, and the pharmacist takes out the powder or liquid medicine from the container and dispenses the powder or liquid medicine. It includes information measured by a digital weigh scale for the weight used in.

Japanese Unexamined Patent Publication No. 2006-167145 Japanese Unexamined Patent Publication No. 2005-10904

However, in recent years, with the promotion of the use of generic drugs and the increase in generic name prescriptions, the rate of incidents of "difference in starting lineup / latecomer" and "difference in product name" in dispensing has been increasing.
There are various factors for the occurrence of incidents in dispensing, but most of them have traditionally been caused by human error.
In the dispensing pharmacy business support system described in Patent Document 2, when dispensing tablets or capsules, for example, when the same drug (tablet or capsule) is picked more than once, the same plurality of IC tags also exist, and the pharmacist Entails the burden of reading the information from each IC tag accurately. Further, when dispensing a powder or a liquid medicine, the pharmacist is burdened with the work of taking out the powder or the liquid medicine from the container and the work of measuring the weight of the medicine used for the preparation. In any of the operations, there is still a risk of human error.
Therefore, in dispensing, since the products handled are pharmaceutical products, not only patients but also pharmacists need psychological support that can be reassured, and new measures are required.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a dispensing audit method, a dispensing audit system, and a dispensing audit program that can prevent the occurrence of incidents in dispensing.

The present invention employs the following means in order to solve the above problems.

One aspect of the present invention is a computer-based dispensing audit method in which the acquisition unit acquires prescription data from a prescription, the reading unit performs in parallel with the acquisition step, or prior to the acquisition step. , The reading step of reading the dispensing data, in which the pharmacist prepared and dispensed the drugs while directly checking the prescription, and the prescription data acquired in the acquisition step and the dispensing data read in the reading step. It has a collation step for collating with, and in the reading step, it is calculated from the type of the drug prepared by the pharmacist and the total weight of the drug prepared by the pharmacist based on the weight data associated with each drug in advance. This is a dispensing audit method, characterized in that the reading unit reads dispensing data including the number or mass of drugs to be treated.

Further, one aspect of the present invention is a dispensing audit system used in the above-mentioned dispensing audit method, in which an acquisition unit that acquires prescription data from a prescription and a pharmacist prepare and dispense drugs while directly checking the prescription. It has a reading unit for reading dispensing data and a collating unit for collating the prescription data acquired by the acquisition unit with the dispensing data read by the reading unit, and the reading unit is prepared by the pharmacist. It is a dispensing audit system provided with a means for calculating the quantity of a drug from the total weight of the drug in a packaged state based on the weight data associated with each drug in advance.

Further, one aspect of the present invention is a dispensing audit program used in the above-mentioned dispensing audit method, in which a computer is used to obtain prescription data from a prescription, and a pharmacist directly confirms the prescription while performing a drug. It is a dispensing audit program for executing a reading step for reading dispensing data and a collation step for collating the prescription data acquired in the acquisition step with the dispensing data read in the reading step.

According to the dispensing audit method, the dispensing audit system, and the dispensing audit program of the present invention, it is possible to prevent the occurrence of incidents in dispensing.

It is a figure which shows the flowchart of the dispensing audit method which concerns on one Embodiment of this invention. FIG. 2A is a schematic view showing a 10-tablet sheet in which 10 tablets 50 are contained in a PTP sheet 10 having an ear portion 15. FIG. 2B is a schematic view showing a 10-tablet sheet in which 10 tablets 50 are contained in a PTP sheet 20 having no ear portion. FIG. 2C is a schematic view showing one tablet of the tablet 50 contained in the PTP sheet 30. FIG. 2D is a schematic view showing a rubber band 40 for collecting the prepared tablets in a packaged state. It is a figure which shows the flowchart which shows an example of the conventional dispensing audit method.

In the dispensing audit method according to one aspect of the present invention, the dispensing data of the medicines collected without waiting for the input of the contents of the prescription (prescription data) to the receipt computer (acquisition of prescription data) is combined with the prescription data input to the receipt computer. It is characterized by the point of matching. In addition, in the reading step, the quantity (number or mass) of the medicines prepared is calculated from the total weight of the medicines prepared by the pharmacist. Known methods, systems, and programs can be appropriately applied to configurations other than the above two points.

FIG. 1 is a diagram showing a flowchart of a dispensing audit method according to an embodiment of the present invention.
In the dispensing audit method of the present embodiment, for example, the reception personal computer, the receipt computer (receipt computer) which is the acquisition unit, the dispensing personal computer which is the reading unit, and the auditing personal computer which is the collation unit are linked with each other, and the whole is as a whole. Perform using a configured pharmacy audit system and pharmacy audit program. The dispensing personal computer includes a plurality of personal computers depending on the dosage form, such as for powder or liquid dispensing and for counting dispensing.

In the flow of the dispensing audit method of the present embodiment, first, the prescription submitted by the patient is accepted (step S001). Regarding the contents of the prescription, check the prescribed items and others. If necessary, make a question inquiry to the doctor who issued the prescription (prescription audit).

Next, the contents of the received prescription (prescription data) are input to the receipt computer (receipt computer) to acquire the prescription data (step S002).
The prescription data input to the receipt computer is transferred to the reception personal computer, and is sent from the reception personal computer to the dispensing personal computer and the audit personal computer, respectively.

Separately from step S002, in parallel or in advance, the medicines are prepared while directly checking the contents (prescription data) of the prescription received by the pharmacist (step S003).
In the present embodiment, dispensing is performed while directly checking the prescription, not based on the prescription data input to the receipt computer. For example, dispensing is performed while checking the original prescription, a copy of the prescription, or the image data of the prescription acquired by a scanner or the like. As a result, it is possible to prevent a dispensing error due to a receipt computer input error. In addition, dispensing can be performed even when the receipt computer and the dispensing location are separated.
Then, the dispensing data such as the barcode attached to each drug is read into the dispensing personal computer. The dispensing data read into the dispensing personal computer is sent to the auditing personal computer.

Next, the prescription data acquired in step S002 is collated with the dispensing data read in step S003, and a final audit is performed (step S004).
As a result of the collation in step S004, if the prescription data sent to the audit personal computer and the dispensing data match, the prescribed medicine is delivered to the patient together with the medication instruction (step S005).
If the prescription data sent to the audit personal computer and the dispensing data do not match as a result of the collation in step S004, the prescription data is incorrect, the dispensing data is incorrect, or both are incorrect. Therefore, the occurrence of incidents can be prevented.

As described above, the dispensing audit method according to the embodiment of the present invention includes an acquisition step, a reading step, and a collation step. The reading step proceeds in parallel with the acquisition step or prior to the acquisition step. Further, the input to the receipt computer (step S002) and the preparation of the drug (step S003) go through separate flows, and finally the prescription data and the dispensing data are collated. As a result, in addition to dispensing errors, input errors to the receipt computer can be checked at the same time. That is, the dispensing audit system applied to the present embodiment has a double check function of a check function for input errors in the receipt computer and a check function for dispensing errors. Therefore, human error can be reduced to the utmost limit, and wrong drug delivery can be prevented. Therefore, according to the dispensing audit method according to the present embodiment, it is possible to prevent the occurrence of an incident in dispensing.

As described above, since the dispensing audit system applied to the present embodiment has a double check function, it is possible to increase the certainty that the dispensed medicine is dispensed according to the prescription through this system. In addition, a higher sense of security than before can be obtained. This system can be a psychological support that can be reassured not only for patients but also for pharmacists.

Further, according to the dispensing audit method according to the embodiment of the present invention, the pharmacist prepares the medicines (dispensing) without waiting for the contents of the prescription (prescription data) to be input to the receipt computer (acquisition of prescription data). Can be done. As a result, the time from receiving the prescription to the start of dispensing can be shortened. In addition, it is possible to continue to prepare the medicines for the next prescription in the order of receiving the prescriptions without waiting for the input of the receipt computer. Further, in the dispensing audit system applied to the present embodiment, since the dispensing data can be held by the collation unit, the dispensing can be advanced prior to the input of the receipt computer.

In addition, the dispensing audit method applying the existing dispensing audit system could not audit powders, liquids, ointments, injections, etc. In the dispensing audit system applied to the present embodiment, it is possible to identify mixed powders, liquids, ointments, injections, etc. by registering the drug in the system in advance of dispensing. This ultimately makes it possible to audit any dosage form. Furthermore, by adopting this system, even if multiple types of preparations such as tablets, powders, liquids, ointments, injections, and external preparations are performed at different locations or by the person in charge, they will be collated (final audit) when they are aggregated. It can be carried out.

Further, in the dispensing audit system applied to the present embodiment, the final audited prescription / dispensing can be confirmed from the history. Therefore, by adopting this system, it is possible to perform pre-audit based on the final audited data. As described above, this system has a function of storing dispensing data and final audited data, and by utilizing this, it is possible to improve the efficiency of dispensing operations.

Although the embodiments of the present invention have been described in detail above, the specific configuration is not limited to the above, and various design changes and the like can be made without departing from the gist of the present invention. Is.

In step S003 (reading step) in the dispensing audit method of the above-described embodiment, by further registering various numbers "codes" assigned to the drugs, the starting product, the generic product, the quantity of the prepared drug, etc. can be obtained. The check can also be performed in step S004 (verification step). Examples of various number "codes" include a GS1 code, a Ministry of Health, Labor and Welfare code, a drug price code, an electronic receipt billing code, and the like. As a result, the double check function of a person can be strengthened. In addition, since each check item is completely matched, it is possible to prevent the wrong drug from being delivered.

The above-mentioned check of the quantity of the prepared medicines can be performed, for example, as follows.

In the dispensing audit method according to the embodiment of the present invention, as step S003 (reading step), the weight associated with each drug in advance from the types of drugs prepared by the pharmacist and the total weight of the drugs prepared by the pharmacist. Examples thereof include a form in which the reading unit reads dispensing data including the number or mass of drugs calculated based on the data.
In step S003 (reading step) of the embodiment, for example, by associating the weight data measured in advance with various numbers "codes" given to the drug, the pharmacist has prepared the packaged drug. The reading unit is provided with a means for calculating the quantity of the drug from the total weight.
As the quantity of the drug, the number of drugs (number of tablets, number of packages) or mass (contents in the container) can be calculated.

Therefore, using a barcode reader and a weighing scale that output to the reading unit, the pharmacist simply reads the number "code" of the prepared medicine with the barcode reader and puts all the prepared medicines in the packaged state on the weighing scale. Then, the dispensing data including the type of the prepared medicine and the number or mass of the prepared medicine is read into the reading unit.
Here, the order of the operation of reading the drug number "code" with a barcode reader and the operation of placing the prepared drug on the weighing scale is not particularly limited, and either may precede or may be performed at the same time. Good.

The weight data is prepared according to the state of the drug (tablets, granules, liquids, etc.), packaging form (PTP (press thruch pack) sheet, injection, tube, ointment pot, dosing bottle, rubber band, etc.). It is possible. For example, the weight data includes the weight of the drug in the packaged state (for example, per tablet, per 10 tablets, per packet, etc.), the weight of the ear portion of the packaging material, the weight of various exterior materials, and the medication. The weight of the bottle (empty state), the density of the liquid agent, the weight of the rubber ring for packing a plurality of packaging materials, and the like can be mentioned.

Hereinafter, the case of a PTP sheet containing tablets as a drug will be described as an example with reference to FIG.
FIG. 2A shows a 10-tablet sheet in which 10 tablets 50 are contained in a PTP sheet 10 having an ear portion 15.
FIG. 2B shows a 10-tablet sheet in which 10 tablets 50 are contained in a PTP sheet 20 having no ear portion.
FIG. 2C shows one tablet 50 contained in the PTP sheet 30.
FIG. 2D shows a rubber band 40 for collecting the tablets in the packaged state.

In step S003 (reading step) of this embodiment, the number of drugs (number of tablets) is calculated from the total weight of the drugs in the packaged state prepared by the pharmacist as follows.

The weight of the package shown in FIG. 2 (a) is 10 g, the weight of the package shown in FIG. 2 (b) is 8 g, and the weight of the package shown in FIG. 2 (c) is 0. The number of tablets is determined when the weight of the rubber ring shown in FIG. 2 (d) is 0.8 g and the weight (total weight) of the packaged drug prepared by the pharmacist is 41.9 g.

[Algorithm 1]
4 packages (40 tablets) in the state shown in FIG. 2 (a) 10 g x 4 = 40 g
Gross weight 41.9g-40g = 1.9g
Two packages (2 tablets) in the state shown in FIG. 2 (c) 0.8 g x 2 = 1.6 g
1.9g-1.6g = 0.3g
Weight of ear part 15 10g-8g = 2g> 0.3g
From this, it is determined that there is a high possibility that the package (without the ear portion) in the state shown in FIG. 2B is not included. It is highly possible that one rubber band (0.3 g) shown in FIG. 2 (d) is contained.
From the above, the number of drug tablets is calculated to be 42.

[Algorithm 2]
One package (1 tablet) 0.8 g in the state shown in FIG. 2 (c)
Gross weight 41.9g-0.8g = 41.1g
4 packages (40 tablets) in the state shown in FIG. 2 (a) 10 g x 4 = 40 g
41.1g-40g = 1.1g
One package (1 tablet) 0.8 g in the state shown in FIG. 2 (c)
1.1g-0.8g = 0.3g
Weight of ear part 15 10g-8g = 2g> 0.3g
From this, it is determined that there is a high possibility that the package (without the ear portion) in the state shown in FIG. 2B is not included. It is highly possible that one rubber band (0.3 g) shown in FIG. 2 (d) is contained.
From the above, there is no error for one tablet, and the number of drug tablets is calculated to be 42.

[Algorithm 3]
Weight of ear part 15 10g-8g = 2g
Gross weight 41.9g-2g = 39.9g
Three packages (30 tablets) in the state shown in FIG. 2 (a) 10 g x 3 = 30 g
39.9g-30g = 9.9g
12 packages (12 tablets) in the state shown in FIG. 2 (c) 0.8 g × 12 = 9.6 g
9.9g-9.6g = 0.3g
Ear part 15 weighs 2g> 0.3g
From this, it is determined that there is a high possibility that the package (without the ear portion) in the state shown in FIG. 2B is not included. It is highly possible that one rubber band (0.3 g) shown in FIG. 2 (d) is contained.
From the above, the number of drug tablets is calculated to be 42.

Since 42 tablets were calculated in all of Algorithms 1, 2, and 3, the number of drugs (number of tablets) prepared by the pharmacist is determined to be 42 tablets.

By adopting step S003 (reading step) of the above embodiment, not only the medicines prepared by the pharmacist and the prescription do not match or do not match, but also the number or mass of the medicines prepared by the pharmacist itself is correct or not (difference in quantity). ) Can be confirmed.
In addition, according to step S003 (reading step) of the embodiment, by making full use of the weight data associated with each drug in advance and associating the weight data with the drug number "code", the total number of the prepared drugs is totaled. Since the quantity (number or mass) is automatically calculated from the weight, it is not necessary to input the quantity data due to picking by human hands.
Further, in step S003 (reading step) of the embodiment, regardless of the type of the drug and the state of the drug (tablets, granules, liquids, etc.), the quantity of any drug from the total weight of the prepared drugs. (Number or mass) can be calculated.
Further, according to step S003 (reading step) of the embodiment, for example, it is possible to prevent the PTP sheet having a plurality of packaging units (presence or absence of ear portion, 10-tablet sheet, 14-tablet sheet, etc.) from being mistaken for each other.

In the conventional audit system for measuring weight, it is permissible if the measured weight is within the theoretically assumed range from the input information of the prescription.

In the dispensing audit method having step S003 (reading step) of the above-described embodiment, in particular, not only the type but also the quantity (number or mass) of all the prepared drugs is input as "dispensing data". Therefore, the "dispensing data" can be sent to the collation step without waiting for the input of the "prescription data" in advance.
As a result, if there is a difference between the "prescription data" and the "dispensing data", a mismatch occurs, suggesting that there is a mistake in either the "prescription data" or the "prepared drugs". As described above, the dispensing audit method according to one embodiment is a useful method having a unique "double check function".

In S004 (verification step) in the dispensing audit method of the above-described embodiment, a plurality of collation units may be further provided. For example, by making it possible to link two or more audit PCs, it is possible to collate each dispensing data read at each location with the prescription data of the same prescription even if the dispensing locations are far apart. .. Alternatively, even if a plurality of persons are in charge of dispensing, the dispensing data of each person in charge can be collated with the prescription data of the same prescription.

Hereinafter, the present invention will be described in more detail with reference to Examples, but the present invention is not limited to these examples.

(Example)
According to the flow of the dispensing audit method shown in FIG. 1, the dispensing audit system applied to one embodiment of the present invention is used to verify the occurrence of incidents after delivery between April 30 and July 31, 2018. went.
As a result, the number of incidents after delivery during the verification period was “zero”.
During the verification period, 48 dispensing mistakes and 3 input mistakes were found by this dispensing audit system. The contents are shown below.
Dispensing mistakes: 16 cases of "quantity difference", 11 cases of "starter product-generic product difference", 9 cases of "product name difference", 8 cases of "standard difference", 4 cases of "dispensing omission" Input error to receipt computer: "starter product" -1 case of "difference in generic product", 2 cases of "difference in quantity"

(Comparison example)
The status of incidents after delivery for the past two years (FY2016, FY2017) according to the flow of the dispensing audit method in Fig. 3 is shown below.

2016: 0.83 cases of incidents after delivery Dispensing mistakes: 1 case of "starter product-difference in generic product", 1 case of "difference in standard", 2 cases of "difference in product name", 2 cases of "difference in quantity" to receipt computer Typing error: 1 case of "difference in quantity", 1 case of "missing input", 1 case of "difference in clinic name / Dr name", 1 case of "difference in standard"

2017: Number of incidents after delivery 0.75 Dispensing mistakes: "Original product-difference from generic product" 2 cases, "difference in standard" 1 case, "difference in quantity" 1 case Input error to receipt computer: "Original product- 2 cases of "difference in generic product", 1 case of "difference in usage", 1 case of "difference in clinic name / Dr name", 1 case of "difference in patient name"

From the above verification results, it can be confirmed that the dispensing audit method, the dispensing audit system, and the dispensing audit program to which the present invention is applied can prevent the occurrence of incidents in dispensing.

10 PTP sheet, 20 PTP sheet, 30 PTP sheet, 40 rubber bands, 50 tablets

Claims (3)

It is a computer-based dispensing audit method.
Acquisition step, in which the acquisition department acquires prescription data from the prescription,
In parallel with the acquisition step or prior to the acquisition step, the reading unit prepares and dispenses the drug while directly checking the prescription, and the reading step for reading the dispensing data and the collating unit are described. It has a collation step for collating the prescription data acquired in the acquisition step with the dispensing data read in the reading step.
In the reading step, the drug calculated from the total weight of each type of drug prepared by the pharmacist and each type of drug in the packaged state prepared by the pharmacist based on the weight data associated with each drug in advance. The reading unit reads the dispensing data including the quantity of each type of
The weight data summarizes the weight of the drug in the packaged state, the weight of the ear portion of the packaging material, the weight of the exterior material, the weight of the empty medication bottle, the density of the liquid agent, and a plurality of packaging materials. Contains at least data selected from the group consisting of the weight of the rubber ring for
The quantity of each type of drug calculated based on the weight data is calculated from the total weight of each type of drug in the packaged state prepared by the pharmacist, the weight of the drug in the packaged state, and the other weight data. A dispensing audit method characterized in that a determination is made based on a plurality of results automatically calculated according to a plurality of algorithms in which the order of subtracting the selected data is different. A dispensing audit system used in the dispensing audit method according to claim 1.
Acquisition department that acquires prescription data from prescriptions,
A pharmacist prepares and dispenses drugs while directly checking the prescription, a reading unit that reads the dispensing data, and a collation that collates the prescription data acquired by the acquisition unit with the dispensing data read by the reading unit. Has a part,
The reading unit is provided with a means for calculating the quantity of each type of drug from the total weight of each type of packaged drug prepared by the pharmacist based on the weight data associated with each drug in advance.
The weight data summarizes the weight of the drug in the packaged state, the weight of the ear portion of the packaging material, the weight of the exterior material, the weight of the empty medication bottle, the density of the liquid agent, and a plurality of packaging materials. Contains at least data selected from the group consisting of the weight of the rubber ring for
The quantity of each type of drug calculated based on the weight data is based on the total weight of each type of drug in the packaged state prepared by the pharmacist, the weight of the drug in the packaged state, and the other weight data. A dispensing audit system that is determined by multiple results that are automatically calculated according to multiple algorithms that deduct the selected data in random order. A dispensing audit program used in the dispensing audit method according to claim 1.
On the computer
The acquisition step of acquiring prescription data from a prescription,
The pharmacist prepares and dispenses the medicines while directly checking the prescription, reads the dispensing data, and collates the prescription data acquired in the acquisition step with the dispensing data read in the reading step. A dispensing audit program for performing the matching steps.

Images