应用信息技术防控PIVAS输液差错实践研究  

Application of information technology in prevention and control of infusion errors in PIVAS

作　　者：辜明 王旭[1] 罗苗 李秋琪 胡艳珂[2] 华小黎[1] Gu Ming;Wang Xu;Luo Miao;Li Qiuqi;Hu Yanke;Hua Xiaoli(Department of Pharmacy,Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430022,Hubei Province,China;Information Department,Union Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430022,Hubei Province,China)

机构地区：[1]华中科技大学同济医学院附属协和医院药学部,武汉430022 [2]华中科技大学同济医学院附属协和医院信息科,武汉430022

出　　处：《中国数字医学》2022年第4期78-84,共7页China Digital Medicine

摘　　要：目的:借助信息技术,对静脉用药集中调配中心(pharmacy intravenous admixture services,PIVAS)的各工作环节进行全流程优化,减少PIVAS输液差错的发生,保障患者输液安全。方法:充分调研分析PIVAS各环节可能出现的差错和原因,绘制鱼骨图,针对重点环节引入信息技术,建立医嘱审核的三重防火墙,在PIVAS管理平台上完善审方规则数据,建立全肠外营养制剂(TPN)审核模块,建立“不合理医嘱干预记录”管理模块;制定批次调整规则,对药品货位等药品信息进行标识,完善输液标签内容数据库等。结果:通过比较引入信息技术前后两个阶段的各环节差错评价指标,结果表明PIVAS各工作环节在引入信息技术后,其差错率大幅下降,同时还提高了工作效率。结论:应用信息技术,对进入PIVAS系统的医嘱进行全流程管理,不仅可以减少输液差错发生率,还可以提高工作效率,保障输液的及时与安全。Objective To optimize the whole process of all work links in PIVAS with the information technology,reduce the occurrence of infusion errors in PIVAS,and ensure the infusion safety of patients.Methods Possible errors in the links of PIVAS and reasons were fully investigated and analyzed,the fishbone diagram was drawn,the information technology was introduced for the key links,the triple firewalls for the audit of advices of doctor were built,the data of prescription auditing rules is supplemented on the PIVAS management platform,and the audit module of total parenteral nutrition(TPN)and management module of"unreasonable intervention record of advice of doctor"were established;batch adjustment rules were formulated,drug information such as position of drug was marked,and infusion label content database was improved,etc.Results By comparing the error evaluation indexes of each link before and after the introduction of information technology,the results showed that the error rate of each link of PIVAS decreased significantly after the introduction of information technology,and the work efficiency was also improved.Conclusion The application of information technology for the whole process management of medical orders entering PIVAS system can not only reduce the incidence of infusion errors,but also improve work efficiency and ensure the timely and safely of infusion.

关 键 词：信息技术 PIVAS 防控 输液差错 临床安全合理用药 

分 类 号：R319[医药卫生—基础医学]