Development and Implementation of Intelligent Management System for Narcotic and Psychotropic Drugs in Inpatient Pharmacy Based on FMEA

OBJECTIVE To establish a full closed-loop traceable system for narcotics and psychotropic drugs through empirical research using failure mode and effect analysis(FMEA), to improve the operation standards of pharmacists and nurses, to improve the risk management level of narcotics and psychotropic drugs and the patients medication safety. METHODS FMEA was used to identify the risk points in the whole process of narcotics and psychotropic drugs management. By calculating the risk priority number(RPN), the risk points for priority improvement were determined. The corresponding improvements measures were formulated and the intervention effect was evaluated. RESULTS For the management of narcotics and psychotropic drugs in the Second Affiliated Hospital of Soochow University, a total of 9 failure modes with medium and high risk level were found, including non-standardized prescriptions, inability to track batch number in the whole process, low recollection rate of empty ampoules, and nonstandard disposal of discarded drugs, et al. After optimization and improvement, the new RPNs were all ≤ 20, and a total of 312 RPNs were reduced, with a descender of 72.6%. The application of intelligent management system for narcotic and psychotropic drugs ran smoothly. The revision rate of prescriptions decreased from 11.56% to 0.95%, the difference was statistically significant(P<0.05). The occurrence of abnormal events decreased from (6.67±0.58)items to 0 per month. The labor cost dropped significantly. Other changes including the recovery rate of empty ampoules, the accuracy rate of batch number management for narcotics and psychotropic drugs, the standard rate of waste drug disposal, and the standard rate of special account books for narcotics and psychotropic drugs were significantly improved, with statistically significant different(P<0.05). CONCLUSION The use of FMEA significantly reduces the risk and harm of narcotic drugs management in inpatient pharmacy. The application of intelligent management system for narcotic and psychotropic drugs has realized the information management. Not only the effective guarantee of narcotic and psychotropic drugs can be traced, but also greatly facilitate the operation of medical staff.