静脉用药调配中心实施精细化管理对输液质量安全的影响
Effect of fine-grained management in PIVAS on the quality and safety of transfusion
目的 探讨静脉用药调配中心(PIVAS)管理方法和模式,全面提升中心质量,为患者提供安全、有效的静脉输液成品,确保输液质量与安全.方法 运用精细化管理的理论和方法,采取建立专业化的岗位职责体系、制定《岗位职责指导书》、细化处方审核和药品管理、控制药品配制关键环节、运用网络信息技术、建立科学的质控体系等措施,对实施前后38个病区的不合理处方、静脉输液药物不良反应及药物配制缺陷情况进行统计分析比较.结果 实施后6个月与实施前同季节的6个月各项指标比较,不合理处方数显著减少(261∶654;x2=160.54,P<0.01);药物不良反应明显下降(139∶193;x2=21.39,P<0.01);配制错误数量显著降低(1∶11;x2=10.29,P<0.01).结论 实施精细化管理适应PIVAS高风险、高强度、高责任心和集约化、流程化管理的特点,在提高PIVAS质量、保证输液安全中成效显著.
更多Objective To discuss the management method and pattern in PIVAS,in order to improve quality,provide patients with safe and effective venous transfusion products,and ensure transfusion quality and safety.Methods The theory and method of fine-grained management was used to build system of professional position responsibility,formulate "position duty instruction",detail prescription verification and medication management,control drug dispensing key link,apply network information technology and establish scientific quality control system,etc.Irrational prescription,adverse effect to venous transfusion products and deflects of drug dispensing in 38 wards were analyzed and compared before and after.Results Irrational prescription reduced from 654 to 261,compared between six months before and six months after fine-grained management,and the difference was statistically significant (x2 =160.54,P < 0.01).Cases of adverse effect to venous transfusion products decreased from 193 to 139,with statistically significant difference (x2 =21.39,P < 0.01).The number of wrong drug dispensing also dropped from 11 to 1,and the difference was statistically significant (x2 =10.29,P < 0.0l).Conclusions Fine-grained management is suitable in PIVAS which has the characteristics of high risk,high intensity,high responsibility,intensification and flow management,thus effective to improve quality in PIVAS and ensure the safety of transfusion.
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