To mitigate risks associated with the prescription examination,marking,dispensing,checking,and review of non-integral-dosage drugs in Pharmacy Intravenous Admixture Service(PIVAS),we formed a project team.Employing th...To mitigate risks associated with the prescription examination,marking,dispensing,checking,and review of non-integral-dosage drugs in Pharmacy Intravenous Admixture Service(PIVAS),we formed a project team.Employing the failure mode and effect analysis(FMEA)management method,we identified potential risks in four critical steps of the non-integral-dosage drug dispensing process within PIVAS drug management:prescription verification,mixed allocation,and verification.For each step,we assigned scores for severity,incidence,and detectability,subsequently calculating the Risk Priority Number(RPN)to prioritize identified risks.Targeted measures for improvement were developed for steps with the highest RPN values.A total of 31 risk factors were documented in the management of non-integral-dosage drugs,with the dispensing process being particularly vulnerable.Specific measures were devised for eight high RPN risks.Following a 3-month optimization and improvement period,RPN values and incidences of internal differences were significantly reduced.The implemented measures demonstrated effective risk control.Notably,we established a comprehensive conversion system for partial-dose drug dispensing,directly translating into a volume of suction fluid for dispensing personnel based on doctor orders.This eliminated the need for manual secondary calculations,thereby standardizing and automating the dispensing of non-integral-dosage drugs in PIVAS.Simultaneously,our project team conducted a dissolution test on 23 types of drugs with non-integral dosage,revealing that the solvent volume increased for 11 types after dissolution.The dosage conversion for partial dosage was recalibrated based on the volume of the final solution to ensure dosage accuracy.Through the application of failure mode and effect analysis,we systematically managed the risks associated with non-integral-dosage drugs in PIVAS.This approach addressed safety concerns in the dispensing process,reduced errors,and ensured the safe and precise administration of medication to patients.展开更多
This paper aims to thoroughly explore the teaching reform of Traditional Chinese Medicine(TCM)dispensing technology in higher vocational colleges,with a focus on the Traditional Chinese Medicine Skills Competition.By ...This paper aims to thoroughly explore the teaching reform of Traditional Chinese Medicine(TCM)dispensing technology in higher vocational colleges,with a focus on the Traditional Chinese Medicine Skills Competition.By analyzing the current teaching status and main challenges of TCM dispensing technology,and aligning with the requirements of the skills competition,a series of detailed and practical teaching reform measures are proposed.These measures are designed to comprehensively improve the teaching quality of TCM dispensing technology in higher vocational colleges,enhance students’practical skills and professional qualities,and ultimately meet the demand for high-quality,skilled talents in the field of TCM.展开更多
Objective:To explore the application of plan–do–check–action(PDCA)cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked me...Objective:To explore the application of plan–do–check–action(PDCA)cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked medicine dispensing medicine management.Methods:The PDCA theory was used to analyze the data,to find out the causes of the problem,and to formulate the corresponding countermeasures to intervene.The data of the naked medicine/adverse drug events satisfaction degree of the inpatients in 18 inpatient departments given for the adoption of PDCA cycle in January 2017 were set as the observation group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before adoption of PDCA cycle in December 2016 was set as the control group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before and after adoption of PDCA cycle was observed and analyzed.Results:The number of the naked medicine/adverse drug events after implementing the method of PDCA cycle management rate was significantly lower than before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).The satisfaction degree of the inpatients after implementing the method of PDCA cycle management rate was significantly higher than that before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).Conclusion:Application of PDCA cycle in the management of the naked medicine dispensing about the automatic package can help to reduce the adverse drug events,to improve the safety of drug treatment,and to increase the patients’satisfaction degree.展开更多
In electronics packaging the time-pressure dispensing system is widely usedto squeeze the adhesive fluid in a syringe onto boards or substrates with the pressurized air.However, complexity of the process, which includ...In electronics packaging the time-pressure dispensing system is widely usedto squeeze the adhesive fluid in a syringe onto boards or substrates with the pressurized air.However, complexity of the process, which includes the air-fluid coupling and the nonlinearuncertainties, makes it difficult to have a consistent process performance. An integrated dispensingprocess model is first introduced and then its input-output regression relationship is used todesign a run to run control methodology for this process. The controller takes EWMA scheme and itsstability region is given. Experimental results verify the effectiveness of the proposed run to runcontrol method for dispensing process.展开更多
To improve the consistency of the adhesive amount dispensed by the time-pressure dispenser for semiconductor manufacturing, a non-Newtonian fluid flow rate model is developed to represent and estimate the adhesive amo...To improve the consistency of the adhesive amount dispensed by the time-pressure dispenser for semiconductor manufacturing, a non-Newtonian fluid flow rate model is developed to represent and estimate the adhesive amount dispensed in each cycle. Taking account of gas compressibility, an intelligent model-based control strategy is proposed to compensate the deviation of adhesive amount dispensed from the desired one. Both simulations and experiments show that the dispensing consistency is greatly improved by using the model-based control strategy developed in this paper.展开更多
To alleviate the influence of gas compressibility on the process performance of time-pressure dispensing for electronics encapsulation,a predictive model is developed based on power-law fluid to estimate the encapsula...To alleviate the influence of gas compressibility on the process performance of time-pressure dispensing for electronics encapsulation,a predictive model is developed based on power-law fluid to estimate the encapsulant amount dispensed.Based on the simple and effective model,a run by run (RbR) supervisory control scheme is delivered to compensate the variation resulting from gas volume change in the syringe.Both simulation and experiment have shown that the dispensing consistency has been greatly improved with the model-based RbR control strategy developed in this paper.展开更多
BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to ad...BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been studied.Since vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED.The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness.METHODS:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 000.Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in 2009.The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness.RESULTS:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the study.Before intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness.展开更多
A new consistency control method for jet dispensing is proposed. First, the working parameters, namely, viscosity, supply pressure and supply time, are experimentally investigated. Then, the glue viscosity is approxim...A new consistency control method for jet dispensing is proposed. First, the working parameters, namely, viscosity, supply pressure and supply time, are experimentally investigated. Then, the glue viscosity is approximated by a polynomial model using the least square method. Based on this model and temperatme control implemented using the Dahlin principle, the viscosity of the glue can be maintained at a constant value. Then, the viscosity model of the glue is applied to deriving the droplet mass as the nominal model of the temperature controller. The robustness of the temperature controller is analyzed by applying the small gain theory. The glue supply pressure controller is designed using the consistency control strategy, and the robustness is analyzed. Finall）, simulations and experiments are conducted using a jet dispensing control system. The results show that the proposed control strategy can significantly improve the droplet consistency.展开更多
For safety reasons,in the automated dispensing medicines process,robots and humans cooperate to accomplish the task of drug sorting and distribution.In this dynamic unstructured environment,such as a humanrobot collab...For safety reasons,in the automated dispensing medicines process,robots and humans cooperate to accomplish the task of drug sorting and distribution.In this dynamic unstructured environment,such as a humanrobot collaboration scenario,the safety of human,robot,and equipment in the environment is paramount.In this work,a practical and effective robot motion planning method is proposed for dynamic unstructured environments.To figure out the problems of blind zones of single depth sensor and dynamic obstacle avoidance,we first propose a method for establishing offline mapping and online fusion of multi-sensor depth images and 3D grids of the robot workspace,which is used to determine the occupation states of the 3D grids occluded by robots and obstacles and to conduct real-time estimation of the minimum distance between the robot and obstacles.Then,based on the reactive control method,the attractive and repulsive forces are calculated and transformed into robot joint velocities to avoid obstacles in real time.Finally,the robot’s dynamic obstacle avoidance ability is evaluated on an experimental platform with a UR5 robot and two KinectV2 RGB-D sensors,and the effectiveness of the proposed method is verified.展开更多
This paper employs computer colour generation,and match prediction systems and aims tofind the most critical change of dye concentration corresponding to changes of Hue,or Chroma,orLightness of 1 unit just visible col...This paper employs computer colour generation,and match prediction systems and aims tofind the most critical change of dye concentration corresponding to changes of Hue,or Chroma,orLightness of 1 unit just visible colour difference,thus investigating the required accuracy level fordyeing dispensing.This leads to the selection of one critical colour-difference dimension of threefrom CMC (1:c) measurement.The results reveal that the concentration change in dye dispensing ismost critical for change of Hue in a computer controlled system.The formula describing the rela-tionship Of △E and △H in CMC (2:1) measurement is selected for further investigation.展开更多
With the numerical simulation and high-speed camera, a series of images of dispensing of rod from different devices were obtained. The process of dispensing of rods driven by aiming explosive charge and the influence ...With the numerical simulation and high-speed camera, a series of images of dispensing of rod from different devices were obtained. The process of dispensing of rods driven by aiming explosive charge and the influence of different structures on dispensing velocity and angle of KE-rod were studied through analyzing the images. All these can be helpful for the design of new concept anti tactical ballistic missile(ATBM) KE-rod warheads.展开更多
Extrusion-based cell deposition has become a prominent technique for expanding bioprinting applications.However,the associated print resolution in the order of nanolitre or above has been a limiting factor.The demand ...Extrusion-based cell deposition has become a prominent technique for expanding bioprinting applications.However,the associated print resolution in the order of nanolitre or above has been a limiting factor.The demand for improving print resolution towards the scale of a single cell has driven the development of precision nozzle extrusion,although the benefits gained remain ambiguous.Here,aided by in situ imaging,we investigated the dynamics of cell organisation through an extrusion-based microcapillary tip with picolitre precision through in-air or immersion deposition.The microcapillary extrusion setup,termed‘Picodis’,was demonstrated by generating droplets of colouring inks immersed in an immiscible medium.Next,using 3T3 fibroblast cells as an experimental model,we demonstrated the deposition of cell suspension,and pre-aggregated cell pellets.Then,the dynamic organisation of cells within the microcapillary tip was described,along with cell ejection and deposition upon exiting the tip opening.The vision-assisted approach revealed that when dispersed in a culture medium,the movements of cells were distinctive based on the flow profiles and were purely driven by laminar fluid flow within a narrow tip.The primary process limitations were cell sedimentation,aggregation and compaction,along with trapped air bubbles.The use of picolitre-level resolution microcapillary extrusion,although it provides some level of control for a small number of cells,does not necessarily offer a reliable method when a specified number of cells are required.Our study provides insights into the process limitations of high-resolution cell ink extrusion,which may be useful for optimising biofabrication processes of cell-laden constructs for biomedical research.展开更多
In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine di...In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine dispensing. However, automating the dispensing, or having it replaced by artificial intelligence (AI) will not, eradicate human error. Thus, measures against human error will continue to serve as an important topic. Therefore, hospitals are required to improve the efficiency of the pharmacy department. For these purposes, attention has now shifted to Supply Processing and Distribution (SPD). In this study, we measured for the gaze of the pharmacist and SPD, and examined the factors affecting dispensing error;moreover, we examined prevention of the human error. In the results of the eye tracking, SPD members tended to spend a greater number of gaze time and gaze counts, for each medicine, on “medicines” and “picking lists,” than pharmacists. On the other hand, when pharmacists picking medicines, they performed various work operations in parallel, such as checking the prescription and looking the next shelf location. It was conjectured that SPD members had more clearly defined items to check when picking, compared to pharmacists. This may have possibly led to a lower chance of dispensing errors being introduced by SPD members. These results suggest that the process of selection is not a mandatory requirement of pharmacists during the action of dispensing. Instead, SPD members, pharmacy assistants, or automatic dispensing devices could serve as substitutes for picking. It is suggested that pharmacists should spend more time and effort on prescription inspection, medicines checking and dosing operations.展开更多
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 ...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, without the inspection of the prescription or checking weighed amount. Irregular doses for infants and older patients require fine adjustments;therefore, the powders dispensing checking system may not find all dispensing errors. It is important for a pharmacist to, first, be written calculated weight on the prescription and checked by themselves, and next to begin dispensation work. In the future, as well as the powdered medication dispensing, it is necessary to make use of measures for preventing errors in the various dispensing process, such as the medication inspection, sterile products preparation, clinical practice et al.展开更多
[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identi...[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.展开更多
Objective： Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage indiabetic patients of the subsidized system of Antioquia. Methodology： A retrospective cohort study...Objective： Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage indiabetic patients of the subsidized system of Antioquia. Methodology： A retrospective cohort study compares the units of analogueinsulin consumed with the expense per patient during the periods of December/l 4-May/15 versus December/15-May/16. Statisticaltreatment is applied to data obtained and the results are analyzed. Results： The expense per patient during the period ofDecember/15-May/16 was statistically less than the one during the same period on the year before （December/14-May/15）, having astate dispensing saving per patient of US$ 1.34 per month. And a saving per patient in the pharmaceutical care is approximatelyUS$ 2.82 per month. Conclusions： Cost savings in care of insulin-dependent diabetic population enrolled in the subsidized plan waspossible due to the development of cost/effective dispensing strategies that allowed access and safety of insulin therapy.展开更多
Objective: to study the effect of PDCA circulation method on the internal difference of drug dispensing in western pharmacy. Methods: 233773 samples of drugs in western medicine pharmacy from January 2019 to December ...Objective: to study the effect of PDCA circulation method on the internal difference of drug dispensing in western pharmacy. Methods: 233773 samples of drugs in western medicine pharmacy from January 2019 to December 2019 in our hospital were randomly divided into study group and control group, with 116890 and 116883 respectively. The study group adopted PDCA circulation method for dispensing, while the control group adopted routine management. The internal difference events of two groups were compared. Results: the total incidence of internal difference events in the study group (0.37%) was significantly lower than that in the control group (0.63%), (P < 0.05). Conclusion: PDCA circulation method can effectively reduce the internal difference events in the dispensing of drugs in western pharmacy.展开更多
Objective: to analyze the causes and key links of drug consumption increase in the intravenous drug dispensing center of our hospital, and to discuss the improvement measures, in order to reduce the waste of resources...Objective: to analyze the causes and key links of drug consumption increase in the intravenous drug dispensing center of our hospital, and to discuss the improvement measures, in order to reduce the waste of resources caused by drug consumption. Methods: the drug consumption data of intravenous drug dispensing center in our hospital in 2020 were summarized, the causes were analyzed and improvement measures were discussed. Results: the drug consumption in the preparation link accounted for 58.43% of the total drug consumption, and the drug consumption in the dispensing link accounted for 34.55% of the total drug consumption. Conclusions: drug preparation and dosing and dispensing are the main links of drug consumption. Strengthening the control of this link is helpful to reduce drug consumption and avoid resource waste.展开更多
Objective: to apply the PDCA cycle management mode to the pharmacy, and to analyze the actual effect and value of this mode to reduce drug dispensing errors. Methods: from January 2021, our pharmacy began to apply PDC...Objective: to apply the PDCA cycle management mode to the pharmacy, and to analyze the actual effect and value of this mode to reduce drug dispensing errors. Methods: from January 2021, our pharmacy began to apply PDCA cycle mode to daily management, taking 40 patients treated in the outpatient pharmacy from 2020 to January 2021 as the comparison group for routine management, and 40 patients admitted from 2021 to January 2022 were treated as the analysis group to carry out PDCA cycle management. The drug management quality, the probability of drug dispensing errors, the patient satisfaction, and the quality of life of the two groups were recorded, and the final data results were compared and analyzed. Results: the number of patients scored on the pharmacy management quality, satisfaction, quality of life and withdrawal status was significantly higher than the patients in the comparison group, and the chance of drug dispensing errors and withdrawal in the management group was significantly lower, and the groups were quite different (P <0.05). Conclusion: the application of PDCA circulation mode in outpatient drug management is conducive to the improvement of drug management quality and the reduction of dispensing error probability, which should be further promoted clinically.展开更多
Objective: to analyze the intervention value of TCM prescription analysis in rational use of TCM dispensing. Methods: 49 TCM prescriptions in TCM Department of our hospital from October 2018 to March 2019 were include...Objective: to analyze the intervention value of TCM prescription analysis in rational use of TCM dispensing. Methods: 49 TCM prescriptions in TCM Department of our hospital from October 2018 to March 2019 were included as the regular group;49 TCM prescriptions of TCM Department of our hospital from April 2019 to October 2019 were selected as the analysis group. The proportion of patients' satisfaction with prescription use, the frequency of adverse drug use risk events, the number of adverse drug reactions and the error rate of TCM dispensing were observed and analyzed. Results: in the comparison of patients' satisfaction ratio of prescription use, the analysis group was significantly higher than the regular group (P < 0.05). In the comparison of the occurrence times of adverse drug use risk events, the times of drug induced side effects and the error rate of TCM dispensing, the analysis group was significantly lower than the regular group (P < 0.05). Conclusion: the application of TCM prescription analysis in TCM dispensing can significantly reduce the risk of adverse drug events, the times of drug induced side effects and the error rate of TCM dispensing, and the patient satisfaction rate is high.展开更多
基金Anhui Provincial Health Research Project Fund(Grant No.AHWJ2023-BAc20143)Pharmaceutical Research Exploration Fund of the First Affiliated Hospital of University of Science and Technology of China(Grant No.YJKJJ04)14th Five Year Plan Anhui Province Medical and Health Clinical Key Specialty Construction Project Support.
文摘To mitigate risks associated with the prescription examination,marking,dispensing,checking,and review of non-integral-dosage drugs in Pharmacy Intravenous Admixture Service(PIVAS),we formed a project team.Employing the failure mode and effect analysis(FMEA)management method,we identified potential risks in four critical steps of the non-integral-dosage drug dispensing process within PIVAS drug management:prescription verification,mixed allocation,and verification.For each step,we assigned scores for severity,incidence,and detectability,subsequently calculating the Risk Priority Number(RPN)to prioritize identified risks.Targeted measures for improvement were developed for steps with the highest RPN values.A total of 31 risk factors were documented in the management of non-integral-dosage drugs,with the dispensing process being particularly vulnerable.Specific measures were devised for eight high RPN risks.Following a 3-month optimization and improvement period,RPN values and incidences of internal differences were significantly reduced.The implemented measures demonstrated effective risk control.Notably,we established a comprehensive conversion system for partial-dose drug dispensing,directly translating into a volume of suction fluid for dispensing personnel based on doctor orders.This eliminated the need for manual secondary calculations,thereby standardizing and automating the dispensing of non-integral-dosage drugs in PIVAS.Simultaneously,our project team conducted a dissolution test on 23 types of drugs with non-integral dosage,revealing that the solvent volume increased for 11 types after dissolution.The dosage conversion for partial dosage was recalibrated based on the volume of the final solution to ensure dosage accuracy.Through the application of failure mode and effect analysis,we systematically managed the risks associated with non-integral-dosage drugs in PIVAS.This approach addressed safety concerns in the dispensing process,reduced errors,and ensured the safe and precise administration of medication to patients.
文摘This paper aims to thoroughly explore the teaching reform of Traditional Chinese Medicine(TCM)dispensing technology in higher vocational colleges,with a focus on the Traditional Chinese Medicine Skills Competition.By analyzing the current teaching status and main challenges of TCM dispensing technology,and aligning with the requirements of the skills competition,a series of detailed and practical teaching reform measures are proposed.These measures are designed to comprehensively improve the teaching quality of TCM dispensing technology in higher vocational colleges,enhance students’practical skills and professional qualities,and ultimately meet the demand for high-quality,skilled talents in the field of TCM.
文摘Objective:To explore the application of plan–do–check–action(PDCA)cycle in the management of the naked medicine dispensing about the automatic package and to analyze the practice improved in the quality of naked medicine dispensing medicine management.Methods:The PDCA theory was used to analyze the data,to find out the causes of the problem,and to formulate the corresponding countermeasures to intervene.The data of the naked medicine/adverse drug events satisfaction degree of the inpatients in 18 inpatient departments given for the adoption of PDCA cycle in January 2017 were set as the observation group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before adoption of PDCA cycle in December 2016 was set as the control group.The number of the naked medicine/adverse drug events satisfaction degree of patients in 18 inpatient departments before and after adoption of PDCA cycle was observed and analyzed.Results:The number of the naked medicine/adverse drug events after implementing the method of PDCA cycle management rate was significantly lower than before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).The satisfaction degree of the inpatients after implementing the method of PDCA cycle management rate was significantly higher than that before the implementation method of PDCA cycle management,and the difference had statistical significance(P<0.05).Conclusion:Application of PDCA cycle in the management of the naked medicine dispensing about the automatic package can help to reduce the adverse drug events,to improve the safety of drug treatment,and to increase the patients’satisfaction degree.
基金This project is supported by National Natural Science Foundation of China (No.50390063, 50390064), Research Grant Council of HK SAR (CityU1086/01E)and City University of HK Applied R&D Project(No.9620002).
文摘In electronics packaging the time-pressure dispensing system is widely usedto squeeze the adhesive fluid in a syringe onto boards or substrates with the pressurized air.However, complexity of the process, which includes the air-fluid coupling and the nonlinearuncertainties, makes it difficult to have a consistent process performance. An integrated dispensingprocess model is first introduced and then its input-output regression relationship is used todesign a run to run control methodology for this process. The controller takes EWMA scheme and itsstability region is given. Experimental results verify the effectiveness of the proposed run to runcontrol method for dispensing process.
基金This work was supported by National Natural Science Foundation of China (No.50390063,50390064)the National Basic Research Program of China (973 Program) (No.2003CB716207).
文摘To improve the consistency of the adhesive amount dispensed by the time-pressure dispenser for semiconductor manufacturing, a non-Newtonian fluid flow rate model is developed to represent and estimate the adhesive amount dispensed in each cycle. Taking account of gas compressibility, an intelligent model-based control strategy is proposed to compensate the deviation of adhesive amount dispensed from the desired one. Both simulations and experiments show that the dispensing consistency is greatly improved by using the model-based control strategy developed in this paper.
基金the startup research foundation of China Three Gorge University (No.0620070124)
文摘To alleviate the influence of gas compressibility on the process performance of time-pressure dispensing for electronics encapsulation,a predictive model is developed based on power-law fluid to estimate the encapsulant amount dispensed.Based on the simple and effective model,a run by run (RbR) supervisory control scheme is delivered to compensate the variation resulting from gas volume change in the syringe.Both simulation and experiment have shown that the dispensing consistency has been greatly improved with the model-based RbR control strategy developed in this paper.
基金supported by a Resident Research Grant from the University of Cincinnati Department of Emergency Medicineby a Research Fellowship Award from the Emergency Medicine Foundationby an Institutional Clinicaland Translational Science Award,NIH/NCRR Grant Number 5UL1RR026314-02
文摘BACKGROUND:Numerous medical conditions require timely medication administration in the emergency department(ED).Automated dispensing systems(ADSs)store premixed common doses at the point-of-care to minimize time to administration,but the use of such automation to improved time to medication administration has not been studied.Since vancomycin is a commonly used empiric antimicrobial,we sought to quantify the effect of using an ADS on time to drug delivery in patients presenting to the ED.The study aimed to determine the efficacy of utilizing an ADS to improve time to administration of vancomycin and determine any negative effects on dosing appropriateness.METHODS:The institional review board approved the retrospective quality improvement study took place in a single,urban academic tertiary care ED with an annual census of 80 000.Study subjects were all patients receiving vancomycin for the management of sepsis between March 1 to September 30,2008 and the same time period in 2009.The primary outcome was the proportion of patients who received vancomycin within one hour of bed placement and the secondary outcome was dosing appropriateness.RESULTS:Sixty-three patients had weight and dosing information available(29 before and 34after intervention)and were included in the study.Before intervention,no patient received vancomycin in less than 60 minutes,while after intervention 14.7%of the patients received it in less than 60minutes(difference in proportions 14.7%,95%CI 0.39%-30.0%,P=0.04).A similar proportion of the patients received correct dosing before and after intervention(44.8%vs.41.2%,difference in proportions 3.7%,95%CI-20.0%-26.7%,P=0.770).CONCLUSION:The use of an ADS may improve the timing of medication administration in patients presenting to the ED without affecting dosing appropriateness.
基金Project(2011CB013104)supported by the National Basic Research Program of China
文摘A new consistency control method for jet dispensing is proposed. First, the working parameters, namely, viscosity, supply pressure and supply time, are experimentally investigated. Then, the glue viscosity is approximated by a polynomial model using the least square method. Based on this model and temperatme control implemented using the Dahlin principle, the viscosity of the glue can be maintained at a constant value. Then, the viscosity model of the glue is applied to deriving the droplet mass as the nominal model of the temperature controller. The robustness of the temperature controller is analyzed by applying the small gain theory. The glue supply pressure controller is designed using the consistency control strategy, and the robustness is analyzed. Finall）, simulations and experiments are conducted using a jet dispensing control system. The results show that the proposed control strategy can significantly improve the droplet consistency.
基金the Interdisciplinary Program of Shanghai Jiao Tong University(No.YG2019QNA25)。
文摘For safety reasons,in the automated dispensing medicines process,robots and humans cooperate to accomplish the task of drug sorting and distribution.In this dynamic unstructured environment,such as a humanrobot collaboration scenario,the safety of human,robot,and equipment in the environment is paramount.In this work,a practical and effective robot motion planning method is proposed for dynamic unstructured environments.To figure out the problems of blind zones of single depth sensor and dynamic obstacle avoidance,we first propose a method for establishing offline mapping and online fusion of multi-sensor depth images and 3D grids of the robot workspace,which is used to determine the occupation states of the 3D grids occluded by robots and obstacles and to conduct real-time estimation of the minimum distance between the robot and obstacles.Then,based on the reactive control method,the attractive and repulsive forces are calculated and transformed into robot joint velocities to avoid obstacles in real time.Finally,the robot’s dynamic obstacle avoidance ability is evaluated on an experimental platform with a UR5 robot and two KinectV2 RGB-D sensors,and the effectiveness of the proposed method is verified.
文摘This paper employs computer colour generation,and match prediction systems and aims tofind the most critical change of dye concentration corresponding to changes of Hue,or Chroma,orLightness of 1 unit just visible colour difference,thus investigating the required accuracy level fordyeing dispensing.This leads to the selection of one critical colour-difference dimension of threefrom CMC (1:c) measurement.The results reveal that the concentration change in dye dispensing ismost critical for change of Hue in a computer controlled system.The formula describing the rela-tionship Of △E and △H in CMC (2:1) measurement is selected for further investigation.
文摘With the numerical simulation and high-speed camera, a series of images of dispensing of rod from different devices were obtained. The process of dispensing of rods driven by aiming explosive charge and the influence of different structures on dispensing velocity and angle of KE-rod were studied through analyzing the images. All these can be helpful for the design of new concept anti tactical ballistic missile(ATBM) KE-rod warheads.
基金supported by the European Research Council(ERC-St G,758865,to YYSH)the financial support from the W.D.Armstrong Trust and the Macao Postgraduate Scholarship Fund。
文摘Extrusion-based cell deposition has become a prominent technique for expanding bioprinting applications.However,the associated print resolution in the order of nanolitre or above has been a limiting factor.The demand for improving print resolution towards the scale of a single cell has driven the development of precision nozzle extrusion,although the benefits gained remain ambiguous.Here,aided by in situ imaging,we investigated the dynamics of cell organisation through an extrusion-based microcapillary tip with picolitre precision through in-air or immersion deposition.The microcapillary extrusion setup,termed‘Picodis’,was demonstrated by generating droplets of colouring inks immersed in an immiscible medium.Next,using 3T3 fibroblast cells as an experimental model,we demonstrated the deposition of cell suspension,and pre-aggregated cell pellets.Then,the dynamic organisation of cells within the microcapillary tip was described,along with cell ejection and deposition upon exiting the tip opening.The vision-assisted approach revealed that when dispersed in a culture medium,the movements of cells were distinctive based on the flow profiles and were purely driven by laminar fluid flow within a narrow tip.The primary process limitations were cell sedimentation,aggregation and compaction,along with trapped air bubbles.The use of picolitre-level resolution microcapillary extrusion,although it provides some level of control for a small number of cells,does not necessarily offer a reliable method when a specified number of cells are required.Our study provides insights into the process limitations of high-resolution cell ink extrusion,which may be useful for optimising biofabrication processes of cell-laden constructs for biomedical research.
文摘In recent years, medical institutions have taken a variety of measures to prevent medical incident. In addition, progress has been made toward the development of a fully automated system for the purpose of medicine dispensing. However, automating the dispensing, or having it replaced by artificial intelligence (AI) will not, eradicate human error. Thus, measures against human error will continue to serve as an important topic. Therefore, hospitals are required to improve the efficiency of the pharmacy department. For these purposes, attention has now shifted to Supply Processing and Distribution (SPD). In this study, we measured for the gaze of the pharmacist and SPD, and examined the factors affecting dispensing error;moreover, we examined prevention of the human error. In the results of the eye tracking, SPD members tended to spend a greater number of gaze time and gaze counts, for each medicine, on “medicines” and “picking lists,” than pharmacists. On the other hand, when pharmacists picking medicines, they performed various work operations in parallel, such as checking the prescription and looking the next shelf location. It was conjectured that SPD members had more clearly defined items to check when picking, compared to pharmacists. This may have possibly led to a lower chance of dispensing errors being introduced by SPD members. These results suggest that the process of selection is not a mandatory requirement of pharmacists during the action of dispensing. Instead, SPD members, pharmacy assistants, or automatic dispensing devices could serve as substitutes for picking. It is suggested that pharmacists should spend more time and effort on prescription inspection, medicines checking and dosing operations.
文摘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, without the inspection of the prescription or checking weighed amount. Irregular doses for infants and older patients require fine adjustments;therefore, the powders dispensing checking system may not find all dispensing errors. It is important for a pharmacist to, first, be written calculated weight on the prescription and checked by themselves, and next to begin dispensation work. In the future, as well as the powdered medication dispensing, it is necessary to make use of measures for preventing errors in the various dispensing process, such as the medication inspection, sterile products preparation, clinical practice et al.
基金Young Scholar Program of Hebei Pharmaceutical Association Hospital Pharmaceutical Research Project(2020—Hbsyxhqn0029)Science and Technology Research and Development Project of Chengde City,Hebei Province(201706A043).
文摘[Objectives]To investigate the effect of healthcare failure mode and effect analysis(HFMEA)on reducing error risk of neonatal parenteral nutrition solution dispensing.[Methods]A research team was established to identify the failure mode(FM)in each link of the formulation process of neonatal parenteral nutrition solution by HFMEA,quantify the severity(S),occurrence(O)and detection(D)of FM,and evaluate FM by risk priority number(RPN).For FM with the values of RPN>16,failure cause analysis was conducted,and corresponding improvement measures were formulated.The weight coefficient and random consistency ratio(CR)of deployment process were calculated in Matlab R2018a by compiling the Analytic Hierarchy Process(AHP)program.Six months after the implementation of improvement measures,the implementation effect was evaluated by comparing the changes of the values of RPN which was evaluated comprehensively and the rate of dispensing errors before and after the implementation of HFMEA.[Results]In the preparation process of neonatal parenteral nutrition solution,a total of 13 FMs with medium and above risk were found,the weight coefficient of medical order review,dosing and mixing was 0.2703,the weight coefficient of drug dispensing check and review was 0.1432,the weight coefficient of print label was 0.1015,the weight coefficient of distribution was 0.0716,and CR=0.0491<0.1.After six months of intervention,the total RPN value decreased by 64.81%from 127.8 to 45.0.The deployment error rates were significantly lower after the implementation,and the difference was statistically significant(P<0.05).[Conclusions]HFMEA can effectively reduce the error risk in preparation of neonatal parenteral nutrition solution,improve the quality of dispensing and promote the safety of neonatal medication.
文摘Objective： Assess the economic impact of the dispensing control strategy implementation on analogue insulin dosage indiabetic patients of the subsidized system of Antioquia. Methodology： A retrospective cohort study compares the units of analogueinsulin consumed with the expense per patient during the periods of December/l 4-May/15 versus December/15-May/16. Statisticaltreatment is applied to data obtained and the results are analyzed. Results： The expense per patient during the period ofDecember/15-May/16 was statistically less than the one during the same period on the year before （December/14-May/15）, having astate dispensing saving per patient of US$ 1.34 per month. And a saving per patient in the pharmaceutical care is approximatelyUS$ 2.82 per month. Conclusions： Cost savings in care of insulin-dependent diabetic population enrolled in the subsidized plan waspossible due to the development of cost/effective dispensing strategies that allowed access and safety of insulin therapy.
文摘Objective: to study the effect of PDCA circulation method on the internal difference of drug dispensing in western pharmacy. Methods: 233773 samples of drugs in western medicine pharmacy from January 2019 to December 2019 in our hospital were randomly divided into study group and control group, with 116890 and 116883 respectively. The study group adopted PDCA circulation method for dispensing, while the control group adopted routine management. The internal difference events of two groups were compared. Results: the total incidence of internal difference events in the study group (0.37%) was significantly lower than that in the control group (0.63%), (P < 0.05). Conclusion: PDCA circulation method can effectively reduce the internal difference events in the dispensing of drugs in western pharmacy.
文摘Objective: to analyze the causes and key links of drug consumption increase in the intravenous drug dispensing center of our hospital, and to discuss the improvement measures, in order to reduce the waste of resources caused by drug consumption. Methods: the drug consumption data of intravenous drug dispensing center in our hospital in 2020 were summarized, the causes were analyzed and improvement measures were discussed. Results: the drug consumption in the preparation link accounted for 58.43% of the total drug consumption, and the drug consumption in the dispensing link accounted for 34.55% of the total drug consumption. Conclusions: drug preparation and dosing and dispensing are the main links of drug consumption. Strengthening the control of this link is helpful to reduce drug consumption and avoid resource waste.
文摘Objective: to apply the PDCA cycle management mode to the pharmacy, and to analyze the actual effect and value of this mode to reduce drug dispensing errors. Methods: from January 2021, our pharmacy began to apply PDCA cycle mode to daily management, taking 40 patients treated in the outpatient pharmacy from 2020 to January 2021 as the comparison group for routine management, and 40 patients admitted from 2021 to January 2022 were treated as the analysis group to carry out PDCA cycle management. The drug management quality, the probability of drug dispensing errors, the patient satisfaction, and the quality of life of the two groups were recorded, and the final data results were compared and analyzed. Results: the number of patients scored on the pharmacy management quality, satisfaction, quality of life and withdrawal status was significantly higher than the patients in the comparison group, and the chance of drug dispensing errors and withdrawal in the management group was significantly lower, and the groups were quite different (P <0.05). Conclusion: the application of PDCA circulation mode in outpatient drug management is conducive to the improvement of drug management quality and the reduction of dispensing error probability, which should be further promoted clinically.
文摘Objective: to analyze the intervention value of TCM prescription analysis in rational use of TCM dispensing. Methods: 49 TCM prescriptions in TCM Department of our hospital from October 2018 to March 2019 were included as the regular group;49 TCM prescriptions of TCM Department of our hospital from April 2019 to October 2019 were selected as the analysis group. The proportion of patients' satisfaction with prescription use, the frequency of adverse drug use risk events, the number of adverse drug reactions and the error rate of TCM dispensing were observed and analyzed. Results: in the comparison of patients' satisfaction ratio of prescription use, the analysis group was significantly higher than the regular group (P < 0.05). In the comparison of the occurrence times of adverse drug use risk events, the times of drug induced side effects and the error rate of TCM dispensing, the analysis group was significantly lower than the regular group (P < 0.05). Conclusion: the application of TCM prescription analysis in TCM dispensing can significantly reduce the risk of adverse drug events, the times of drug induced side effects and the error rate of TCM dispensing, and the patient satisfaction rate is high.
