細胞毒性藥品自動調製系統之引進與成效評估

Implementation and Performance Evaluation of an Automatic Compounding Robot for Injectable Cytotoxic Drugs

化療注射劑的調製，對藥師及醫院都是具高度專業性及特殊性的業務，須由經過訓練的藥師，於符合規範的負壓清淨室進行。然而即使完全遵循標準作業程序操作，傳統人工調製的方式，仍對人員及環境造成暴露於危害性藥品的風險，且在高度壓力下容易發生人為因素的調劑錯誤，危及用藥安全。近年隨著醫療科技的進步，越來越多自動化，設備被使用於藥品調劑以減少錯誤、避免危害、改善流程及活化人力。本文以本院引進國內第一套新型細胞毒性藥品自動調製系統的過程為例，分享從事前評估、前置作業、使用概況、到效能優化等經驗，期能幫助國內外有意引進自動化調製設備的醫院選擇適合的設備，並能發揮預期效益，改善調劑環境及醫療品質。

The compounding of injectable anticancer drugs is a highly professional and unique business for pharmacists and hospitals, and must be carried out by well-trained pharmacists in certified negative pressure clean rooms. However, even if all the standard operating procedures are correctly executed, the traditional manual compounding process still poses the risk of hazardous drug exposure to personnel and the environment. Heavy workloads also lead to increased human errors which jeopardizing medication safety. With the advancement of compounding technologies in recent years, more automated devices were adopted to reduce errors, avoid hazards exposure, improve workflow and utilize the pharmacy personnel. This article describes the process of introducing the first automatic compounding robot by a medical center in northern Taiwan, and shares the experiences of assessment, pre-work, performance, and optimization. We hope these experiences could help hospitals to choose automated compounding devices that suit their own units and take the expected benefits, where improve the compounding environment and the quality of medical services.