细节思维管理法对静脉用药调配中心输液微粒的控制效果分析  

Analysis of Control Efficacy of Details Thinking Management on Infusion Particle in Pharmacy Intravenous Admixture Services

作　　者：段元青 

机构地区：[1]莱芜钢铁集团有限公司医院药剂科,山东莱芜271100

出　　处：《中国药房》2017年第5期694-698,共5页China Pharmacy

摘　　要：目的:评价细节思维管理法对静脉用药调配中心(PIVAS)输液微粒的控制效果。方法:选取我院2014年1-12月(实施前组)和2015年1-12月(实施后组)由PIVAS配制的临床常用输液的相关资料各1 200份、住院患者各150例,比较强化工作制度、提高人员素质、全程落实实施等细节思维管理实施前后PIVAS不同等级洁净区悬浮粒子及沉降菌数量、配制输液中微粒数量和微粒所致不良反应发生情况。结果:细节思维管理法实施后,PIVAS不同等级洁净区悬浮粒子和沉降菌数量均较实施前显著降低,差异均有统计学意义(P<0.05);电解质类、中药注射剂类、消化系统用药类配制输液中≥10μm及≥25μm的微粒数,抗菌药物类配制输液中≥10μm的微粒数和维生素类配制输液中≥25μm的微粒数均较实施前显著减少,配制输液中橡胶及玻璃污染微粒的数量亦显著减少,差异均有统计学意义(P<0.05);患者血管阻塞、水肿、静脉炎和热原反应等不良反应发生率均较实施前显著降低,差异均有统计学意义(P<0.05)。结论:细节思维管理法的实施可提高PIVAS不同等级洁净区的洁净度,减少各类配制输液中的微粒数量,从一定程度上提高了配制输液的质量,保障患者的用药安全。OBJECTIVE：To evaluate the control efficacy of details thinking management on the infusion microne in pharmacy intravenous admixture services（PIVAS）.METHODS：One thousaud and two hundred infusion information dispensed by PIVAS and 150 inpatients were collected from our hospital during Jan.-Dec.2014（before implementation group） and Jan.-Dec.2015（after implementation group）.The number of suspended particles and sedimentated bacteria in different levels of clean area in PIVAS,the number of particles in dispensed infusion and the occurrence of ADR caused by infusion particles were compared before and after the implementation of details thinking management as strengthening working system,improving the quality of staff,implementing management during whole process,etc.RESULTS：After the implementation of details thinking management,the number of suspended particles and sedimentated bacteria in different levels of clean area were decreased significantly compared to before implementation,with statistical significance（P〈0.05）.The number of particles ≥10μm and ≥25 μm among electrolyte,TCM injection and digestive system agents infusion,the number of particles ≥10 μm among antibiotics infusion and the number of particles ≥25μm among vitamin infusion were all decreased significantly compared to before implementation;the number of rubber and glass particles among dispensed infusion were decreased significantly with statistical significance（P〈0.05）.The incidence of ADR as blood vessel blockage,edema,phlebitis and heat source reaction were all decreased compared to before implementation,with statistical significance（P〈0.05）.CONCLUSIONS：The implementation of details thinking management can improve clean degree of different levels of clean area in PIVAS,and reduce the number of particles in various dispensed infusion so as to improve the quality of dispensed infusion to certain extent and guarantee the safety of drug use.

关 键 词：细节思维管理 静脉用药调配中心 输液微粒 控制效果 

分 类 号：R952[医药卫生—药学]