药房拆零药品精细化管理模式探索  

Refined Management Mode of Dismounted Drugs in the Pharmacy

作　　者：光琴 张蕾[2] 卢今[1] 余记双 GUANG Qin;ZHANG Lei;LU Jin;YU Jishuang(Anhui Provincial Hospital Infection Hospital·Hefei Infectious Disease Hospital,Hefei,Anhui,China 230001;Anhui Provincial Hospital,Hefei,Anhui,China 230001)

机构地区：[1]安徽省立医院感染病院·安徽省合肥市传染病医院,安徽合肥230001 [2]安徽省立医院,安徽合肥230001

出　　处：《中国药业》2022年第13期25-29,共5页China Pharmaceuticals

基　　金：安徽省重点研究与开发计划项目[201904a07020092];安徽省高等学校省级质量工程项目[2019jyxm0972]。

摘　　要：目的建立医院药房固体口服拆零药品(以下简称拆零药品)精细化管理模式,促进安全、合理使用拆零药品。方法建立最小包装药品拆零调配管理制度,制订拆零药品目录,细化药品拆零质量管理检查指标。实施一系列改进措施,包括增加药品拆零详细电子信息,制作药品裸片识别图,重新确定拆零分装后药品的有效期,加强拆零药品的质量控制等。通过医院信息系统的临床药学服务平台拆零药品电子记录的查询功能,收集2018年6月至11月(优化前)、2018年12月至2019年5月(优化后)的拆零药品信息,并根据药品质量管理检查指标评价拆零药品管理和使用合理情况。结果优化后,拆零药品质量管理检查指标合理率为84.00%,显著高于优化前的52.40%(P<0.01)。优化后,仍存在拆零损耗导致账物不符、用药错误未全部及时上报等问题。结论加强拆零药品精细化管理,可有效提高拆零药品的管理和使用水平,提高用药安全性,但仍需积极上报相关的用药错误,并及时干预,避免药房拆零药品质量管理中的不良事件发生。Objective To establish a refined management mode of solid oral dismounted drugs(hereinafter referred to as dismounted drugs)in the hospital pharmacy,and to promote safe and rational use of dismounted drugs.Methods A management system for the dismounting and dispensing of the smallest packaged drugs was establised,a catalogue of the dismounted drugs was formulated,and the inspection indicators for the quality management of the dismounted drugs were refined.A series of implemented improvement measures were as follows:increasing the detailed electronic information of dismounted drugs,making identification diagram of non-blister-packed tablets,redefining the expiration date of drugs after dismounting and repacking,and strengthening the quality control of dismounted drugs.Through the query function of the electronic records of dismounted drugs in the Clinical Pharmacy Service Platform of the Hospital Information System(HIS),the information of dismounted drugs from June to November 2018(before optimization)and December 2018 to May 2019(after optimization)was collected,and the rationality of management and use of dismounted drugs was evaluated according to the inspection indicators for quality management of drugs.Results After optimization,the reasonable rate of inspection indicators for quality management of dismounted drugs was 84.00%,which was significantly higher than 52.40%before optimization(P<0.01).After optimization,there were still some problems such as the accounts and materials were inconsistent due to the loss caused by dismounting,and the medication errors were not all reported in time.Conclusion Strengthening the refined management of dismounted drugs can effectively improve the management and use of dismounted drugs,and improve the safety of medication.However,it is necessary to actively report and intervene relevant medication errors in time to avoid the occurrence of adverse events in the quality management of dismounted drugs in hospital pharmacy.

关 键 词：固体口服拆零药品 精细化管理 检查指标 安全用药 药房管理 

分 类 号：R952[医药卫生—药学]