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FMEA模型和6S管理方法在降低儿童专科医院PIVAS调剂差错中的应用
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| 篇名： | FMEA模型和6S管理方法在降低儿童专科医院PIVAS调剂差错中的应用 |
| TITLE： | Application of FMEA model and 6S management method in reducing dispensing errors in PIVAS of children’s hospitals |
| 摘要： | 目的 降低儿童专科医院静脉药物配置中心（PIVAS）的调剂差错。方法采用失效模式和效应分析（FMEA）模型，对我院PIVAS调剂流程进行风险识别，找出各环节中可能导致调剂差错的潜在失效模式，分析其失效原因，并对潜在失效模式的严重度、发生率和检测度进行量化评分，计算其风险优先指数，从而筛选需要优先改善的失效模式；应用6S管理方法，从整理（seiri）、整顿（seiton）、清扫（seiso）、清洁（seiketsu）、素养（shitsuke）和安全（safety）6个方面制定相应的改善措施，并对实施前后的干预效果进行评价。结果根据风险优先指数评估筛选出32个潜在失效模式，其中需要优先改善的关键失效模式共18个。根据6S管理方法采取相应措施后，18个关键失效模式的风险优先指数均有所下降，风险优先指数值由497降至142，降幅达71.43%；其中15个关键失效模式的差错率均较实施前显著降低（P＜0.05）。结论应用FMEA模式和6S管理方法对PIVAS工作流程的各环节进行风险管控的预测和改进，能有效降低PIVAS调剂差错风险，保障儿童静脉用药安全。 |
| ABSTRACT： | OBJECTIVE To reduce dispensing errors in pharmacy intravenous admixture service （PIVAS） of children’s hospitals. METHODS The risk of dispensing procedures in our PIVAS was identified by applying failure mode and effect analysis （FMEA） model. Potential failure modes that might lead to dispensing errors in each link were determined， and failure causes were analyzed. The severity， incidence and detection degree of potential failure modes were quantitatively scored， and their risk priority number （RPN） was calculated to screen failure modes that needed to be improved in priority； the corresponding improvement measures were developed by 6S management method from six aspects， namely， finishing （seiri）， rectifying （seiton）， sweeping （seiso）， sanitation （seiketsu）， literacy （shitsuke） and safety. The effect of intervention before and after rectification was evaluated. RESULTS Based on the RPN， 32 potential failure modes were selected， of which a total of 18 critical failure modes that needed to be improved in priority. After implementing corresponding measures according to 6S management method， the RPN of 18 critical failure modes decreased. The total RPN decreased from 497 to 142 with a decrease rate of 71.43%. The error rates of 15 critical failure modes were significantly lower than before implementation （P＜0.05）. CONCLUSIONS Applying FMEA model and 6S management method to the risk control of all aspects of PIVAS workflow can effectively reduce the risk of PIVAS dispensing errors and ensure the safety of children’s intravenous medication. |
| 期刊： | 2024年第35卷第02期 |
| 作者： | 何林峰；杨亚亚；林芸竹；杨春松；张伶俐 |
| AUTHORS： | HE Linfeng，YANG Yaya，LIN Yunzhu，YANG Chunsong，ZHANG Lingli |
| 关键字： | 静脉药物配置中心；调剂差错；风险评估；失效模式和效应分析；6S管理 |
| KEYWORDS： | pharmacy intravenous admixture service； dispensing errors； risk evaluation； failure mode and effect analysis； 6S |
| 阅读数： | 59 次 |
| 本月下载数： | 7 次 |
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