改进升级静脉用药调配中心管理系统对工作质量和效率的影响研究  

Effects of Improving and Upgrading the Management System of Pharmacy Intravenous Admixture Service on Work Quality and Efficiency

作　　者：王喜丹[1] 叶晓云[1] 贺雯[1] 庞成森[1] 董卫华[1] 封卫毅[1] WANG Xidan;YE Xiaoyun;HE Wen;PANG Chengsen;DONG Weihua;FENG Weiyi(Dept.of Pharmacy,the First Affiliated Hospital of Xi'an Jiaotong University,Shaanxi Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院药学部,陕西西安710061

出　　处：《中国医院用药评价与分析》2021年第8期1003-1006,1009,共5页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：陕西省科学技术研究发展计划项目(No.2019KRM092)。

摘　　要：目的:评价西安交通大学第一附属医院(以下简称“我院”)静脉用药调配中心(pharmacy intravenous admixture service,PIVAS)管理系统的改进升级对PIVAS工作效率与工作质量的影响。方法:我院于2019年底对PIVAS的功能和架构重新设计和优化,包括将医嘱后置审核升级为前置审核、优化用药批次和瓶签打印等。对2019—2020年我院PIVAS实施的医嘱进行回顾性分析,根据PIVAS新系统实施时间不同,将2019年的医嘱划分为改进前,将2020年的医嘱划分为改进后,比较改进前后的不合理医嘱拦截率和工作效率。结果:改进后,我院PIVAS的不合理医嘱拦截率较改进前显著提高,差异有统计学意义[4.38‰(8533/1948511)与0.90‰(1724/1915675)比较,χ^(2)=4417.150,P<0.001]。改进后,常规药品不合理医嘱拦截率[0.64‰(1253/1948511)与0.19‰(355/1915675)比较,χ^(2)=486.587,P<0.001]、细胞毒性药物不合理医嘱拦截率[0.15‰(293/1948511)与0.01‰(26/1915675)比较,χ^(2)=218.996,P<0.001]和全胃肠外营养药物不合理医嘱拦截率[0.09‰(176/1948511)与0.02‰(44/1915675)比较,χ^(2)=76.982,P<0.001]均较改进前显著提高,医嘱同步时间(t=101.468,P<0.001)、批次优化耗时(t=129.802,P<0.001)和打印耗时(t=57.816,P<0.001)均较改进前显著缩短,上述差异均有统计学意义。结论:改进升级后的PIVAS管理系统显著提高了PIVAS各环节的工作效率和工作质量,值得推广应用。OBJECTIVE:To evaluate the effects of improving and upgrading the management system of pharmacy intravenous admixture service(PIVAS)in the First Affiliated Hospital of Xi an Jiaotong University(hereinafter referred to as“our hospital”)on work quality and efficiency.METHODS:At the end of 2019,our hospital redesigned and optimized the function and architecture of PIVAS,including upgrading the post-review of medical orders to pre-review,optimizing drug batch and bottle label printing.Medical orders implemented in PIVAS of our hospital from 2019 to 2020 were retrospectively analyzed.According to different implementation time of new PIVAS system,the medical orders in 2019 were extracted as before improvement,and the medical orders in 2020 were extracted as after improvement,and the interception rate and work efficiency of irrational medical orders before and after improvement were compared.RESULTS:After improvement,the rate of interception of irrational medical orders in PIVAS of our hospital was significantly higher than those before improvement,and the difference was statistically significant[4.38‰(8533/1948511)compared with 0.90‰(1724/1915675),χ^(2)=4417.150,P<0.001].After improvement,the interception rate of irrational medical orders for conventional general drugs[0.64‰(1253/1948511)compared with 0.19‰(355/1915675),χ^(2)=486.587,P<0.001],the interception rate of irrational medical orders for cytotoxic drugs[0.15‰(293/1948511)compared with 0.01‰(26/1915675),χ^(2)=218.996,P<0.001]and the interception rate of irrational medical orders for total parenteral nutrition drugs[0.09‰(176/1948511)compared with 0.02‰(44/1915675),χ^(2)=76.982,P<0.001]were significantly higher than those before improvement,the synchronization time of medical orders(t=101.468,P<0.001),batch optimization time(t=129.802,P<0.001)and printing time(t=57.816,P<0.001)were significantly shorter than those before improvement,with statistically significant differences.CONCLUSIONS:The upgraded PIVAS management system has significantl

关 键 词：静脉用药调配中心 信息管理系统 前置审核 

分 类 号：R97[医药卫生—药品]