基于医疗失效模式和效应分析的静脉用药集中调配中心新型管理策略  

New management strategy of pharmacy intravenous admixture services based on health failure mode and effect analysis

作　　者：杨婕[1] 张艾娜 周文文[1] YANG Jie;ZHANG Aina;ZHOU Wenwen(Changzhou Hospital of Traditional Chinese Medicine,Changzhou,Jiangsu,213003,China)

机构地区：[1]常州市中医医院,江苏常州213003

出　　处：《中西医结合护理(中英文)》2025年第2期185-188,共4页Journal of Clinical Nursing in Practice

摘　　要：目的分析基于医疗失效模式和效应分析(HFMEA)的静脉用药集中调配中心(PIVAS)新型管理策略对提高输液安全质量的影响。方法自2022年3月至2023年2月,以常州市中医医院的42名药物配置人员,以及同时期调配单量为研究对象,比较基于HFMEA的PIVAS新型管理策略实施前(2022年3~8月)和实施后(2022年9月至2023年2月)的输液安全质量工作指标、管理质量、药物不合理配置发生率、其他科室对PIVAS满意率变化。结果新型管理策略实施后的排药时间、药物配置时间、药物库存周转时间及输液成品交接时间均较实施前明显缩短(P均<0.05)。新型管理规范实施后的配伍禁忌、药物存放、药物剂量、溶剂剂量和溶剂选择管理质量评分均较实施前明显上升(P均<0.05)。药物不合理配置总发生率由新型管理策略实施前的0.10%降至实施后的0.02%(P<0.05)。其他科室对PIVAS的总满意率由新型管理策略实施前的88.10%升至实施后的96.43%(P<0.05)。结论基于HFMEA建立的PIVAS新型管理策略能够提高输液安全质量和管理质量,降低药物不合理配置发生率,并改善其他科室的满意度。Objective To analyze the impact of the new management strategy of the pharmacy intravenous admixture services(PIVAS)based on the health failure mode and effect analysis(HFMEA)on improving the safety and quality of infusion.Methods From March 2022 to February 2023,a study was conducted on 42 drug compounders from Changzhou Hospital of Traditional Chinese Medicine,as well as the number of dispensing orders during the same period.In the study,the changes were compared in infusion safety and quality indicators,management quality,incidence of unreasonable drug dispensing,and satisfaction rate of PIVAS in other departments before(from March to August 2022)and after(from September 2022 to February 2023)the implementation of the new PIVAS management strategy based on HFMEA.Results The drug dispensing time,the drug compounding time,the turnover time of drug inventory,and the handover time of finished infusion products after the implementation of the new management strategy were significantly reduced compared with those before the implementation(P<0.05).After the implementation of the new management strategy,the quality scores of compatibility contraindications,drug storage,drug dosage,solvent dosage,and solvent selection management had significantly increased compared with those before the implementation(P<0.05).The overall incidence of unreasonable drug compounding decreased from 0.10%before the implementation of the new management strategy to 0.02%after the implementation(P<0.05).The overall satisfaction rate of PIVAS in other departments increased from 88.10%before the implementation of the new management strategy to 96.43%after the implementation(P<0. 05). Conclusion The PIVAS new management strategy based on HFMEA can improve the safety and management quality of infusion, reduce the incidence of unreasonable drug compounding, and improve the satisfaction of other departments.

关 键 词：静脉用药集中调配中心 医疗失效模式和效应分析 输液质量 

分 类 号：R472[医药卫生—护理学]