静脉用药调配中心抗菌药物配制的精益管理  

Lean management in preparation of antibacterial drugs in Pharmacy Intravenous Admixture Service(PIVAS)

作　　者：王莉[1] 郑蓉[2] 鲍祎敏 陈满满 姜孝颖 孙纯[3] Wang Li;Zheng Rong;Bao Yimin;Chen Manman;Jiang Xiaoying;Sun Chun(Nursing Department,Wuhan NO.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院护理部,湖北武汉430022 [2]武汉市第一医院心内科,湖北武汉430022 [3]武汉市第一医院静脉调配中心,湖北武汉430022

出　　处：《护理学杂志》2021年第23期50-54,共5页Journal of Nursing Science

基　　金：湖北省卫生健康委员会科研项目(WJ2019F020)。

摘　　要：目的提高静脉用药调配中心抗菌药物配制质量。方法对静脉用药调配中心抗菌药物配制实施精益管理,包括完善空间布局、优化审方系统、加强目视化管理、细化配制环节、改良运输环节,改进质控流程。对精益管理前(2019年5~7月)与管理后(2020年8~10月)各环节指标进行比较。结果精益管理后,抗菌药物日均审方时间、摆药时间、配制时间、出仓打包时间及配送时间显著缩短(均P<0.01);抗菌药物不合格医嘱及调配环节差错发生率显著下降,配制后药物微粒显著降低(均P<0.01);临床科室护理人员满意率显著提升(P<0.01)。结论实施精益管理优化静脉用药调配中心抗菌药物调配流程,可降低药物配制差错率,提高配制时效性,保障临床用药安全。Objective To improve the quality of antibacterial drugs preparation in Pharmacy Intravenous Admixture Service(PIVAS).Methods Lean management was applied in antibacterial drugs preparation in PIVAS,with measures including:making better spatial layout of PIVAS,optimizing prescription checking system,ratcheting up visualization in management,refining the medicine preparation process,modifying transportation process,and mending quality control process.Before(May to July 2019)and after(August to October 2020)lean management practice,the relevant process outcome indicators were compared.Results The daily prescription checking time,dispensing time,preparing time,packing time and delivery time for antibacterial drugs were significantly lower than those before lean management practice(P<0.01 for all);the rates of non-qualified prescriptions and errors,and the number of particles in prepared drug saw a significant drop from before(P<0.01 for all).The satisfaction rate of nursing staff was significantly higher than before lean management(P<0.01).Conclusion Implementation of lean management in PIVAS can optimize the preparation and dispensing processes of antibacterial drugs,reduce the incidence rate of errors in drug preparation,improve the timeliness of drug preparation,and ensure medication safety in clinical settings.

关 键 词：静脉用药调配中心 精益管理 抗菌药物 药物配制 用药安全 护理管理 

分 类 号：R472.9[医药卫生—护理学] C931[医药卫生—临床医学]