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静脉制剂外配处方闭环管理模式构建与探索
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| 篇名： | 静脉制剂外配处方闭环管理模式构建与探索 |
| TITLE： | Development and exploration of a closed-loop management model for externally dispensed intravenous prescriptions |
| 摘要： | 目的 构建静脉制剂外配处方全流程闭环管理模式，为静脉制剂外配处方规范化管理提供参考。方法基于我院前期牵头制定的《静脉制剂外配处方闭环管理广西专家共识》，通过多学科团队头脑风暴法与鱼骨图框架，系统识别全流程风险点，制定并实施限定外配合作药店与药品目录、运维医院信息系统和静脉用药调配中心（PIVAS）智能管理平台、强化全链条人员差异化培训等策略，构建以PIVAS为核心枢纽、日间化疗中心为安全终端的全流程闭环管理体系。结果共遴选出3家合作药店及涵盖35个品规的首期药品目录，成功构建了涵盖医院门诊开药、患者药店购药、PIVAS配药和日间化疗中心用药四大模块的闭环管理流程，实现了静脉制剂外配处方与院内溶媒的强制关联成组、药品追溯码的全程核验、输注参数的智能监测与全流程数据追溯。结论所构建的模式有效解决了静脉外配药品从院外流转至院内使用的衔接与安全管控问题，初步实现了流程的标准化、信息的可追溯化与用药风险的主动防控。 |
| ABSTRACT： | OBJECTIVE To construct a closed-loop management model for externally dispensed intravenous prescriptions， and to provide reference for standardized management of externally dispensed intravenous prescriptions. METHODS Based on the Expert Consensus on Closed-loop Management of Externally Dispensed Intravenous Prescriptions in Guangxi Zhuang Autonomous Region previously formulated by our hospital， risk points during the entire process were systematically identified through multidisciplinary team brainstorming and a fishbone diagram. A series of strategies were subsequently formulated and implemented， including qualifying designated external dispensing pharmacies and the drug catalogs， operating and maintaining the hospital information system and the Pharmacy Intravenous Admixture Service （PIVAS） intelligent management platform， and strengthening differentiated training for staff in the whole workflow. A whole-process closed-loop management system was constructed with PIVAS as the co re hub and the daytime chemotherapy center as the safety terminal. RESULTS A total of 3 cooperating pharmacies and an initial drug list comprising 35 product specifications were selected. A closed‑loop management process encompassing hospital outpatient prescribing， patient drug purchase in designated pharmacies， PIVAS drug dispensing， and medication use in daytime chemotherapy center was successfully established. This system enabled the mandatory grouping and association of externally dispensed intravenous prescriptions with in-hospital diluents， full-process verification based on drug traceability codes， intelligent monitoring of infusion parameters， and whole-process data traceability. CONCLUSIONS The constructed model effectively resolves the coordination and safety oversight during the use of externally dispensed intravenous drugs from out-of-hospital circulation to in-hospital use， and has preliminarily enabled procedural standardization， whole-process information traceability， and proactive control of medication risks. |
| 期刊： | 2026年第37卷第10期 |
| 作者： | 谢旭华；伍云；黄松清；黄煜堃；陈思妍；曾铮；唐微艳；何佐隆；周春霞；张宏亮 |
| AUTHORS： | XIE Xuhua，WU Yun，HUANG Songqing， HUANG Yukun，CHEN Siyan，ZENG Zheng，TANG Weiyan，HE Zuolong，ZHOU Chunxia，ZHANG Hongliang |
| 关键字： | 静脉制剂外配处方；静脉用药调配中心；闭环管理；日间化疗；双通道政策 |
| KEYWORDS： | externally dispensed intravenous prescriptions； |
| 阅读数： | 1 次 |
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