基于医疗失效模式与效应分析降低静脉用药集中调配中心贵重药品管理与使用风险  

Reducing the risk of valuable medicines management and use in PIVAS based on healthcare failure mode and effect analysis

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作  者:刘绪星 梁焕笑[1] 吴玲[1] 邓树荣[1] 梁浩斌 邓秀娇 金伟军[1] LIU Xuxing;LIANG Huanxiao;WU Ling;DENG Shurong;LIANG Haobing;DENG Xiujiao;JIN Weijun(Department of Pharmacy,The First Affiliated Hospital of Ji'nan University,Guangzhou,Guangdong 510630,China)

机构地区:[1]暨南大学附属第一医院药学部,广东广州510630

出  处:《安徽医药》2025年第5期1052-1056,共5页Anhui Medical and Pharmaceutical Journal

摘  要:目的应用医疗失效模式与效应分析(HFMEA)构建降低贵重药品管理与使用风险的模式,促进用药安全,减少经济损失。方法2023年5月暨南大学附属第一医院运用HFMEA找出贵重药品管理与使用的潜在失效模式,对所有潜在失效模式分别进行严重度(S)和发生率(O)评分,计算风险优先指数(RPN),对高风险失效模式进行决策树分析,得出需要采取改善行动的潜在失效模式,制定相应的改善方案并实施,统计分析HFMEA实施前后RPN值,评估改善效果。结果应用HFMEA法后,贵重药品管理与使用各环节的失效模式RPN值下降范围为67.74%~74.36%,改善前后对比差异有统计学意义(P<0.05),相关不良事件数以及报损金额均降为0。结论运用HFMEA可以使贵重药品管理制度标准化、调配规范化以及成品输液输注标准化,有效降低贵重药品管理与使用的风险,并使护理质量提升。Objective To develop a model for reducing risk in the management and use of valuable medicines using healthcare failure mode and effect analysis(HFMEA),so as to promote safe drug administration,and minimize economic losses.Methods HFMEA was employed to identify potential failure modes in the management and use of valuable medicines in the First Affiliated Hospital of Ji'nan University at May 2023.All identified failure modes were scored based on severity(S)and occurrence(O),and the risk priority number(RPN)was calculated.High-risk failure modes were further analyzed using decision tree analysis to determine potential failure modes that necessitate improvement actions.Formulating improvement programs and implementing them,we conducted statistical analysis on the RPN values before and after the implementation of HFMEA to evaluate the effectiveness of the improvements.Results After applying the HFMEA method,the RPN values for failure modes in various stages of valuable medicines management and use decreased by 67.74%to 74.36%.There was a statistically significant difference between the values before and after the improvements(P<0.05).Additionally,the number of related adverse events and the amount of reported losses both dropped to zero.Conclusions The application of HFMEA can standardize the management system,regulation of preparation,and standardized infusion of finished products for valuable medicines.This effectively reduces the risks associated with the management and use of valuable medicines and enhances the quality of nursing care.

关 键 词:药品监督管理 药剂科 医院 贵重药品 医疗失效模式与效应分析法 药品管理与使用 风险防范 破损药品金额 

分 类 号:R95[医药卫生—药学]

 

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