基于FMEA法的住院药房智能药柜用药安全研究  

Medication Safety of Automated Dispensing Cabinet in Inpatient Pharmacy Based on FMEA Method

作　　者：倪倩[1] 方丽涌[2] 吴娜[1] 王涛[1] 王一淳 周莫菲 陈露露[1] 姚晨蕊 谭玲[1] 金鹏飞[1] NI Qian;FANG Liyong;WU Na;WANG Tao;WANG Yichun;ZHOU Mofei;CHEN Lulu;YAO Chenrui;TAN Ling;JIN Pengfei(Beijing Hospital·National Center of Gerontology·Institute of Geriatric Medicine,Chinese Academy of Medical Sciences·Beijing Key Laboratory of Assessment for Clinical Risk and Individual Application of Drugs,Beijing,China 100730;Information Center,Beijing Hospital,Beijing,China 100730)

机构地区：[1]北京医院·国家老年医学中心·中国医学科学院老年医学研究院·北京市药物临床风险与个体化应用评价重点实验室,北京100730 [2]北京医院信息中心,北京100730

出　　处：《中国药业》2024年第4期1-5,共5页China Pharmaceuticals

基　　金：中央高水平医院临床科研业务费资助项目[BJ-2021-223]。

摘　　要：目的提高住院药房智能药柜(ADC)的用药安全管理。方法采用失效模型和效应分析(FMEA)法,经医院护士、药师等讨论后,从信息系统、人员操作、药品信息、硬件设备、管理方法5个方面建立20个失效模型(包括32个风险点),汇总为调查问卷,并通过专家咨询和药师讨论后建立问卷评分标准。于干预前发放问卷进行调查,根据发现的风险对其中30个可操作的风险点设定干预措施,持续干预5个月后(干预后)再次进行问卷调查,比较干预前后的风险优先级数(RPN)。结果干预后,30个风险点的RPN值均不同程度降低,其中22个显著降低(P<0.05)。管理方法方面的全部风险点RPN值均显著降低(P<0.05);硬件设备方面的全部风险点RPN值均无显著改变(P>0.05)。结论FMEA法用于住院药房ADC的用药安全研究,可减少其用药风险,促进药护共同管理安全使用ADC规则的形成,尤其适用于麻醉药品等特殊药品的用药管理。Objective To promote the medication safety management of automated dispensing cabinet(ADC)in inpatient pharmacies.Methods After discussion among nurses and pharmacists in the hospital,the failure mode and effect analysis(FMEA)method was used to construct 20 failure modes(including 32 risk points)from the information system,personnel operation,drug information,hardware and management method.The above content was formulated as questionnaires,and the scoring criteria were constructed through expert consultation and pharmacist discussion.Before the intervention,the questionnaires were distributed for investigation.Based on the identified risks,the intervention measures were formulated for 30 operational risk points.After the continuous intervention for five months(after intervention),a questionnaire survey was conducted again to compare the Risk Priority Number(RPN)before and after the intervention.Results After intervention,the RPN of 30 risk points decreased to varying degrees,with 22 significantly decreased(P<0.05).After intervention,the RPN of all risk points in the management method significantly decreased(P<0.05),and the RPN of all risk points in the hardware was similar to that before intervention(P>0.05).Conclusion The application of FMEA method in the study of medication safety for ADC in inpatient pharmacies can decrease its medication risk,and promote the formation of rules for the safe use of ADC through joint management of pharmacists and nurses.FMEA method is particularly suitable for the management of special drugs such as anesthetics.

关 键 词：智能药柜 用药安全 失效模式与效应分析 住院药房 药品管理 

分 类 号：R95[医药卫生—药学]