Implémentation d’armoires sécurisées dans une unité de soins intensifs. Quels sont les impacts observés sur la gestion des stocks de médicaments, les ressources humaines, les finances et la satisfaction du personnel ?

Details

Supervisors

Quennery, Stefanie ; Duray Clémence

Faculty

Faculté de pharmacie et des sciences biomédicales

Degree label

Master de spécialisation en pharmacie hospitalière

Abstract

Abstract Background: Secure cabinets (SC) are implemented to reduce medication errors in the medication process. First of all, secure cabinets ensure better management of drug stocks, resulting in reduced financial losses due to expiring drugs and improved billing practices. Moreover, SC enhance medication traceability through the computer system, storing crucial information about users, quantities administered, and patients involved. Finally, they enable nurses' time to be reallocated to care activities. In May 2023, ten SC have been implemented in the Intensive Care Unit of Helora University Hospital Center (CHUH) - Jolimont Site. Objectives: In the context of implementing SC, a study was conducted to assess their impact on the allocation of human resources, the management of drugs stocks and the satisfaction of care staff. A cost-benefit analysis was also performed to evaluate the financial aspects of the project. Method: A before-and-after interventional study was conducted in the Intensive Care Unit of Helora University Hospital Center (CHUH) - Jolimont Site. Three follow-up indicators were defined based on a literature review and a SWOT analysis: human resources, quality and safety, finances. These indicators were assessed at two different periods (P1 and P2): before and after the implementation of SC. In the end of the whole study period, satisfaction questionnaires were distributed to nursing staff in the Intensive Care Unit and to the pharmacy staff. Results: About human resources, there is a significant reduction of the time spent by nurses on ordering and storing medicines (-61 minutes per day) following the implementation of SC. On the other hand, pharmacy technicians have experienced an increase in the time allocated to prepare and store medication orders (+143.25 minutes per day). For quality and safety, the study shows a significant increase in the number of additional restocks (+500%) and a major decrease in the number of additional dispensations (-50%) after the implementation of SC. Financially, SC ensure that all drugs are billed, avoiding an average annual loss of 21.293 euros due to non-billing. Overall, satisfaction questionnaires reveal a positive feedback by users of SC. Conclusion: This study reveals the main impacts observed after implementing ten SC in the Intensive Care Unit at CHUH-Jolimont Site. Our results are in line with the literature, indicating that SC lead to a reallocation of working time for those involved in the medication circuit, enabling nursing staff to devote more time to care activities. In addition, SC offer optimal traceability and management of medications, as well as long-term financial benefits.