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静脉用药集中调配中心全面质量管理体系的构建与应用
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| 篇名： | 静脉用药集中调配中心全面质量管理体系的构建与应用 |
| TITLE： | Construction and application of total quality management system in pharmacy intravenous admixture service |
| 摘要： | 目的 构建静脉用药集中调配中心（PIVAS）全面质量管理体系，促进临床静脉输液的规范化、精确化、合理化。方法依托医院PIVAS信息系统，制定PIVAS输液配制前、配制中及配制后全流程的管理制度、确定质量监控项目，以PDCA循环、品管圈、根因分析等质量管理工具与方法，定期进行质控与质量改进。回顾性分析PDCA循环干预前（2019年）及干预后（2020、2021年）PIVAS主要质控指标情况。结果PIVAS输液配制全过程的质量监测指标如药品质量管理得分、药液残留量合格率与输液配制含量合格率分别由2019年的92分、79%、86.4%提高至2021年的99分、92%、99.8%；安全合理用药指标如静脉输液不合理医嘱占比、退药率、抗菌药物使用率、中药注射剂使用率分别由0.98%、6.1%、40.55%、39.70%降至0.23%、3.2%、37.18%与26.00%。结论构建的PIVAS全面质量管理体系能提升输液配制过程中质量管理水平，提高输液配制质量，促进临床安全合理用药。 |
| ABSTRACT： | OBJECTIVE To establish a total quality management system for pharmacy intravenous admixture services （PIVAS）， in order to promote the standardization， accuracy and rationalization of clinical intravenous infusion. METHODS Based on information system in PIVAS， the management system and quality monitoring items of the whole process before， during and after PIVAS infusion preparation were formulated. The quality control and quality improvement were carried out regularly with quality management tools and methods such as PDCA （plan， do， check， process） cycle， quality control circle， and root cause analysis. The main quality control indexes of PIVAS were retrospectively analyzed before （in 2019） and after PDCA cycle management （in 2020 and 2021）. RESULTS The indexes of quality monitoring in the whole process of PIVAS infusion preparation， such as the score of drug quality management， the drug residue qualification rate and the qualified rate of drug content in infusion， were increased from 92 points， 79%， 86.4% in 2019 to 99 points， 92%， 99.8% in 2021， respectively. The indexes of safe and rational drug use， such as the ratio of intravenous irrational medical orders， the rate of drug repercussion， the rate of antibiotics use， and the rate of TCM injection use decreased from 0.98%， 6.1%， 40.55%， 39.70% to 0.23%， 3.2%， 37.18%， 26.00%， respectively. CONCLUSIONS The established total quality management system for PIVAS can improve the quality management level in the infusion preparation process， improve the quality of infusion preparation and promote clinical safe and rational drug use. |
| 期刊： | 2023年第34卷第15期 |
| 作者： | 方宝霞；吴松潮；刘菁；王嗣岑；陈富超 |
| AUTHORS： | FANG Baoxia，WU Songchao，LIU Jing，WANG Sicen，CHEN Fuchao |
| 关键字： | 静脉用药集中调配中心；全面质量管理；质量改进；输液质量；输液安全 |
| KEYWORDS： | pharmacy intravenous admixture services； total quality management； quality improvement； infusion quality； safe |
| 阅读数： | 87 次 |
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