心血管术后重症病房智能药柜机使用的质量改进实践  

The practice of quality improvement of using Automated Dispensing Cabinet in cardiovascular surgery Intensive Care Unit

作　　者：李永刚 黄雨佳 张茜 兰俊 李庆印 石丽 LI Yonggang;HUANG Yujia;ZHANG Qian;LAN Jun;LI Qingyin;SHI Li(The First Adult Surgical Recovery Room,Fuwai Hospital,Chinese Academy of Medical Sciences,Beijing,100037,China)

机构地区：[1]中国医学科学院阜外医院成人外科恢复室一区,北京市100037 [2]中国医学科学院阜外医院护理部,北京市100037

出　　处：《中国护理管理》2021年第4期588-591,共4页Chinese Nursing Management

摘　　要：目的:评价持续质量改进在提升临床护士对智能药柜机的使用满意度及临床护士药品取用便捷性和安全性方面的作用。方法:建立团队,定期对智能药柜机使用情况进行分析,并针对智能药柜机使用过程中存在的主要问题制定改进措施,护士实施持续质量改进并评价效果。结果:2015年4月至2019年12月期间,先后发现智能药柜机使用过程中存在的主要问题20项,并针对其先后制定质量改进方案40个,对药品取用流程中的4个环节进行改进,并新增3个药品取用环节。经过持续质量改进后,护士对智能药柜机内药品摆放合理性、药品识别准确性、药品取用便捷性、麻醉和一类精神药品取用安全性、药品取用制度整体满意度均有所提高(P<0.05);护士临时医嘱取药时间由(5.19±1.12)min缩短至(4.61±0.93)min(P<0.05),临时医嘱退药时间从(3.59±1.20)min缩短至(2.89±1.10)min(P<0.05),护士取药错误发生率从0.7%降低至0.3%(P<0.05)。结论:护士对智能药柜机的使用进行持续质量改进,优化了智能药柜机内部药品存储方式和临床护士用药流程,提升了临床护理用药便捷性和安全性,实现了护理用药流程的闭合管理。Objective:To evaluate the effect of continuous quality improvement in optimizing clinical nurses'satisfaction with the use of Automated Dispensing Cabinet(ADC),and the convenience and safety of nurses'access to medicines.Methods:A team was set up to investigate and analyze the use of ADC,and formulate improvement measures for the main problems.Nurses implement continuous quality improvement and evaluate the effects.Results:From April 2015 to December 2019,20 major problems were discovered,and 40 quality improvements and 3 new processes were made for it,and 4 processes were revised.After continuous quality improvement,nurses were satisfied with the rationality of drug placement,the accuracy of drug identification,the convenience of drug access,the safety of anesthesia and first-class psychoactive drugs access,and the overall satisfaction of drug access system(P<0.05).The time for nurses to take temporary medicine order was shortened from(5.19±1.12)min to(4.61±0.93)min(P<0.05),and the time for temporary medical order withdrawal was shortened from(3.59±1.20)min to(2.89±1.10)min(P<0.05).The incidence of nurses taking medicine errors was reduced from 0.7%to 0.3%(P<0.05).Conclusion:After continuous improvement of improving the use of ADC,the medicine storage method and the clinical nursing medication process were optimized.The convenience and safety of clinical nursing medication was improved,and the closed management of the nursing medication process was realized.

关 键 词：心血管疾病 重症护士 智能药柜机 持续质量改进 

分 类 号：R47[医药卫生—护理学]