基于失效模式与效应分析法的麻醉手术科住院患者麻精药品处方的管理改进  

Based on the failure mode and effect analysis of anesthesia surgery in hospital patients anesthetic and psychoactive drug pre⁃scription management improvement

作　　者：徐玲玲[1] 杜萍[1] 张转运[1] 孙玉娥[1] 马正良[1] Xu Lingling;Du Ping;Zhang Zhuanyun;Sun Yu'e;Ma Zhengliang(Department of Anesthesiology,Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院麻醉手术科,南京210008

出　　处：《国际麻醉学与复苏杂志》2024年第12期1290-1296,共7页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金(82071229);南京大学中国医院改革发展研究院课题(NDYG2022070)。

摘　　要：目的基于失效模式与效应分析法(FMEA)构建麻醉手术科住院患者麻醉药品及精神药品(简称麻精药品)处方的智能信息化管理流程。方法基于FMEA法识别麻精药品处方管理全过程的风险点,通过计算风险优先值(RPN)确定优先改善的风险点,在南京大学医学院附属鼓楼医院麻精药品处方管理过程中共找出人员、处方、签章及制度4个主要维度,涉及14个中高风险等级的失效模式。制订相应的智能化改革措施,并对实施效果进行评价。结果实施信息智能化改革后,14个失效模式均降为中低风险,实施前RPN为45.36±16.07,实施后RPN为11.79±5.71;合格处方率由86.70%上升到98.90%;麻精药品批号准确率、专册登记完整率、知识知晓率得到改善,医护工作人员的开方时间及核方时间缩短,医护人员的工作满意度提升,差异均有统计学意义(均P<0.05)。结论基于FMEA法构建的麻精药品处方信息智能化管理改革不仅降低了麻精药品处方管理的风险值,也显著提高了处方的合格率,极大程度节约了人力成本,提高用药安全。Objective To construct an intelligent information management process of anesthetic and psychotropic drug prescription for inpatients in anesthesia and surgery department based on failure mode and effect analysis(FMEA).Methods Based on the FMEA method,the risk points in the whole process of anesthetic and psychoactive drug prescription management were identified,the risk points for priority improvement were determined by calculating the risk priority number(RPN),in the process of anesthetic and psychoactive drug prescription management in Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,four main dimensions were identified,including personnel,prescription,signature and system,involving 14 failure modes with medium and high‑risk levels.The corresponding intelligent reform measures were formulated,and the implementation effect was evaluated.Results After the implementation of information intelligence reform,14 failure modes were all reduced to low and medium risk,and the RPN value was 45.36±16.07 before the implementation and 11.79±5.71 after the implementation.The qualified prescription rate increased from 86.7%to 98.9%;the accuracy rate of anesthetic and psychotropic drugs batch number,the completeness rate of special registration,and the awareness rate of knowledge were improved;the prescribing time and checking time of medical staff were shortened;the job satisfaction of medical staff was improved,and the differences were significant(all P<0.05).Conclusions Based on the FMEA method to build the anesthetic and psychiatric drug prescribing information intelligent management reform not only reduces the anesthetic and psychiatric drug prescription management risk value but also significantly raises the qualification rate of prescription,greatly saves manpower cost,enhances the medication safety.

关 键 词：麻醉药品 精神药品 处方 失效模式与效应分析 智能管理 

分 类 号：R95[医药卫生—药学]