我国92家医院儿童静脉推注用药品集中调配现状调查  

Current status of centralized admixture of intravenous injection drugs at 92 domestic hospitals

作　　者：陈祯桢 米文杰[2] 陈瑶[1] 张燕[2] 李林[2] CHEN Zhen-zhen;MI Wen-jie;CHEN Yao;ZHANG Yan;LI Lin(Department of Pharmacy,Women&Children's Hospital,School of Medicine,Xiamen University,Xiamen Maternal&Children's Healthcare Center,Fujian Xiamen 361003,China;Services of Pharmacy Intravenous Admixture,Qilu Hospital,Shandong University,Shandong Jinan 250012,China)

机构地区：[1]厦门大学附属妇女儿童医院/厦门市妇幼保健院药学部,福建厦门361003 [2]山东大学齐鲁医院静脉用药调配中心,山东济南250012

出　　处：《中国医院药学杂志》2021年第2期220-223,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:通过调查目前国内医院静脉用药调配中心集中调配儿童静脉推注用药品的现状,对该领域潜在的风险和问题进行分析,进一步促进儿童静脉推注用药品用药安全水平的提高。方法:采用问卷调查的方式,通过山东大学齐鲁医院全国PIVAS微信群,进行线上问卷发放,对回收的有效问卷数据进行统计分析。结果:基本信息:共收集有效问卷92份,涉及92家医院,其中16家开展了儿童静脉推注用药品集中调配工作。风险点:在已开展儿童静脉推注用药品集中调配的16家医院中,对于直接接触成品输液的包材,50%的医院选择原溶媒输液袋、43.75%选择普通注射器、18.75%选择螺口组合件注射器;近半数的医院,40%以上的静脉推注用药品需排液;调配后成品的外包装,包材为注射器时63.64%选择无菌盘,18.18%选择无菌袋,18.18%选择清洁袋;对于成品输液核对环节,注射器为包材时,63.64%在核对包装区内进行,18.18%选择在调配间内,18.18%在操作台。发生漏液情况:16家医院中有12家偶有发生调配后成品的漏液,4家未发生漏液。结论:儿童是高风险用药人群,各医院集中调配儿童静脉推注用药品时在直接接触成品输液的包材、非整袋溶媒的排液方式、成品包装核对等方面存在差异,并存在不同程度的安全隐患。直接接触成品输液的包材选择不多,其中螺口组合件注射器较普通注射器的密封性更好,漏液率低。另外在洁净级别高的环境下使用无菌外包装材料进行调配后成品的核对包装,更能保证成品输液的无菌和安全。目前该领域亟须行业统一的规范或指南的指引,行业协会、制药企业、医疗器械厂家、医疗机构等多方协作努力才能保障儿童静脉推注用药安全。OBJECTIVE To explore the current status of centralized allocation of intravenous injection drugs in domestic hospitals,analyze the potential risks and problems and improve the safety level of intravenous injections in children.METHODS Through an online survey via a WeChat group of Pharmacy Intravenous Admixture Service(PIVAS)built by Qilu Hospital,the relevant data were collected and statistically analyzed.RESULTS A total of 92 valid questionnaires were collected from 92 domestic hospitals.And 16 hospitals carried out centralized allocation of intravenous injection drugs in children and 50%,43.75% and 18.75% of them selected original solvent infusion bags,ordinary syringes and screw assemblies respectively.For nearly half of hospitals,over 40%of intravenous injections required liquid drainage.When wrapping finished products in outer parts,the packaging materials were syringes.And 63.64%,18.18%and 18.18%of them adopted aseptic plates,aseptic bags and cleaning bags respectively;During the inspections of finished products,63.64%,18.18%and 18.18%of them worked in packing areas for verifying,mixing rooms and operation platforms respectively.Finally 12/16 hospitals occasionally had finished products with leakage after deployment and another 4 without leakage. CONCLUSION Children are drug users with high risks.Wide institutional variations exist in infusion packages in direct contacts with finished products,disassembling method for whole bag solvent and packaging check-up of finished products,etc.There are limited choices of package materials in direct contacts with finished infusion products.Screw assembly syringe has a better sealing performance and a lower leakage rate than ordinary counterparts.In environments of high-level cleanliness,check-up of sterile outer packing materials for finished products may ensure the sterility and safety of finished infusion products.Currently there is an urgent need for unified industry norms or guidelines in this field.Only close collaborations of industry associations,pharmaceutica

关 键 词：静脉用药集中调配 儿童 静脉推注用药品 用药安全 问卷调查 

分 类 号：R942[医药卫生—药剂学]