医院加强药品质量管理保证用药安全分析

随着我国医药市场的迅速发展，药品安全问题日益突显，近几年发生了一系列触目惊心的药品安全问题，“齐二药”假药案、“欣弗”事件、鱼腥草注射液夺命事件及久已存在仍很严重的滥用抗生素问题、假狂犬病疫苗问题等…。这些药品安全问题的出现，给患者的生命安全造成了严重危害，引起了社会的广泛关注，也向我国药品安全责任相关部门提出了新的挑战。根据《国家食品药品安全“十一五”规划》，药品安全责任体系涉及地方政府、监管部门和企业三个方面，涵盖了各方在药品安全上应当承担的政治责任、     

我国药品安全定义和范畴的系统综述和定性访谈

目的：深入探讨药品安全的定义和范畴,为药品安全监管工作提供政策性建议。方法：采用系统综述方法,对近10年来相关中、英文数据库及网站中提及药品安全概念、范畴,或对保障药品安全策略和措施的文章分析、整理和综合,总结出药品安全所包含的主要内容;利用定性访谈了解药品监管人员、医务工作者和专业技术人员对于药品安全概念和范畴的认识,以及当前影响药品安全的重要问题。结果：系统综述纳入290篇文献,其中6篇给出了药品安全的定义,纳入文献对于药品安全的定义侧重于药品不良反应／事件监测、避免用药错误、风险管理以及可及性方面。药品安全的范畴主要包括药品监管、药品不良反应／事件、药品保障、药品研发、药品生产、药品流通、药品使用和药品信息获取;定性访谈结果显示,大部分受访者认为药品安全涵盖所有与药物相关的工作,现阶段质量问题和不合理用药是受访者集中反映的药品安全的主要问题。结论：通过综合分析,我们将药品安全定义为通过对药品研发、生产、流通、使用全环节进行监管所表现出来的消除或控制了外在威胁和内在隐患的综合状态,以及为达到这种状态所必要的供应保障和信息反馈。其范畴可以界定为质量符合标准、不良反应在可接受的范围内、临床无用药差错和可及性四个部分。     

药品慎用，罢演问题药品悲剧

每个人都会生病,生病时人们的第一反应就是求医问药。千百年来,人类一直把肉体的痊愈甚至于生命的延续寄托于药品,药品在人们的眼中就是健康的代名词,有了药品才有健康,有了健康才有幸福。然而,面对近年来药品安全问题频出的现象,许多人不禁对药品使用产生了质疑。患者如何正确选择适用的药品？如何选择有质量保证的药品？如何正确使用药品？维护药品给予人类健康的使命,关注药品慎用问题,是近年来我国政府一直严肃对待的事情。2009年伊始,当人们还来不及从曾经的药品安全事故的回顾中抬头,新的药品安全问题又凸显出来。在人类的健康保护区内,让我们来共同清醒了解新的药品安全问题,明确药品慎用问题新航标。     

药品安全管制的经济学分析

药品安全问题产生的主要原因是交易中存在信息不对称.文章利用博弈论对药品市场交易进行分析,研究影响药品安全管制的各种因素,并围绕这些因素对如何完善我国药品安全管制提出了相应的对策和建议.     

西药房高危药品的管理与用药安全探究

目的:为更有效确保西药的用药安全,进一步推动高危药品的管理,保障病人就医安全.方法:通过对西药房的高危药品进行检查,观察记录药品摆放、药品使用剂量、警告标签等高危药品存在的问题,分析总结然后提出整改措施.结果:西药房存在高危药品的概念掌握问题、警告标签问题、药品摆放问题及用药安全等一系列问题,需加以分析整改,以提高用药安全性.结论:药物使用对病人意义重大,通过正确合理服药药物可改善病人的病情,因此,西药房应提高对高危药品的管理和用药安全的重视,从而确保病人用药安全.     

医院药品库房管理优化措施探讨

目的探讨医院药品库房管理优化的措施。方法选取洛阳市某医院药品库房中的100种药品作为观察对象,并对2017年1—12月药品库房管理过程中出现的问题进行整改,提出相应优化措施,然后再将2018年1—12月实行优化措施后的医院药品库房管理情况与实行前进行对比。比较实行医院药品库房管理优化措施前后药品安全问题的发生情况及药品安全管理、质量管理评分。结果医院药品库房管理优化前,药品安全问题的发生率为13.00%。而医院药品库房管理优化后,药品安全问题的发生率为2.00%,明显低于优化前,差异有统计学意义(P0.05)。医院药品库房管理优化后,药品安全管理及质量管理评分均明显高于优化前(P0.05)。结论针对主要问题对医院药品库房管理进行优化,制定可行性措施,可有效降低药品安全问题的发生率,提高药品使用安全性,提升医院管理水平。     

营造安全可信的药品集中采购环境——数字证书在药品集中采购平台上的应用

依托互联网平台开展药品集中采购,已成为当前我国深化医疗卫生体制改革,解决"看病难、看病贵"问题的重要手段。各地在实施互联网药品集中采购过程中,均面临着网络虚拟性所带来的业务运营安全风险。如何解决互联网药品采购中交易身份、交易时间、交易行为、交易内容的可信性保障成为影响业务安全运营的关键问题。本文通过分析现有药品集中采购平台的安全现状,提出了基于数字证书的整体安全解决方案,从而解决了药品集中采购平台的网络信任问题,极大地促进了药品集中采购业务的发展。     

刍议医院高危药品的管理

药品安全问题关系到人民群众的切身利益,越来越受到社会各界的广泛关注。高危药品成为继毒、麻、精药品之后,又一个我们全社会必须重视和了解的一类高风险性药品。本文通过对高危药品的概念、医院高危药品管理与使用的现状进行了阐述,浅谈了加强高危药品管理,提高患者用药安全提出几点建议。     

从齐二药事件再谈加强GMP管理的重要性

从齐二假药案至"欣弗"事件,短短3个月涉及药品安全事件接踵而至,在全国引起了强烈震惊,从中暴露出一些企业对药品质量缺乏严格的科学管理和监控。药品安全涉及药品生产、销售及流通各个环节,任何一个环节出现问题都将导致药品安全问题的产生。     

药品说明书——临床用药安全的保障

近年来,药品导致的严重医疗安全事件引起了医疗界的高度重视,用药安全已经成为党和政府、医疗机构十分重视的课题.威胁用药安全的原因错综复杂,既有药品本身的问题,也有医务人员滥用药品的因素.为进一步正确使用药品,提高用药安全性,我院根据医疗安全的特点,在全院医务人员中开展学习药品说明书的活动,提高大家科学、合理、规范使用药品的能力.     

The Relationships Among Occupational Safety Climate,Patient Safety Climate,and Safety Performance Based on Structural Equation Modeling

ObjectivesThe aim of the present study was to investigate the relationships among hospital safety climate, patient safety climate, and safety outcomes among nurses.MethodsIn the current cross-sectional study, the occupational safety climate, patient safety climate, and safety performance of nurses were measured using several questionnaires. Structural equation modeling was applied to test the relationships among occupational safety climate, patient safety climate, and safety performance.ResultsA total of 211 nurses participated in this study. Over half of them were female (57.0%). The age of the participants tended to be between 20 years and 30 years old (55.5%), and slightly more than half had less than 5 years of work experience (51.5%). The maximum and minimum scores of occupational safety climate dimensions were found for reporting of errors and cumulative fatigue, respectively. Among the dimensions of patient safety climate, non-punitive response to errors had the highest mean score, and manager expectations and actions promoting patient safety had the lowest mean score. The correlation coefficient for the relationship between occupational safety climate and patient safety climate was 0.63 (p<0.05). Occupational safety climate and patient safety climate also showed significant correlations with safety performance.ConclusionsClose correlations were found among occupational safety climate, patient safety climate, and nurses’ safety performance. Therefore, improving both the occupational and patient safety climate can improve nurses’ safety performance, consequently decreasing occupational and patient-related adverse outcomes in healthcare units.     

苏州市15家重大危险源企业职业安全行为的影响因素

[目的]研究职业安全行为的影响因素,为企业的职业健康安全管理工作提供科学依据。[方法]以问卷调查的方式,对苏州市的15家重大危险源企业职工按工种分层抽样调查,回收有效问卷436份。调查内容包括企业安全行为和职工的基本情况、安全行为、安全知识、安全态度、安全心理因素、风险意识、情绪7个方面。[结果]经过单因素方差分析,不同年龄、不同月收入职工的安全行为差异均有显著性(P<0.05和P<0.01)。采用多元线性回归分析,一般相关因素中进入方程的显著性变量是月收入和性格,职业相关因素中进入回归方程的显著性变量是企业安全行为、职工的安全心理和安全知识。[结论]企业安全氛围是职工个人安全行为的主要影响因素,开展安全教育,帮助职工树立积极的安全心理,对促进和引导职工的安全操作行为具有积极意义。     

Structure of safety climates and its effects on workers' attitudes and work safety at Japanese construction work sites

In this study, the nature of safety climates at construction work sites and workers' safety attitudes was ascertained, and the effect of safety climates on workers' safety attitudes and work site safety was examined. A self-rating questionnaire prepared for this study was delivered to 300 employees who were working at construction sites and 300 foremen of affiliated companies. Eight factors were extracted for the safety climate of work sites. Similarly, by factor analysis, eight factors were obtained from workers' safety attitudes, including four factors representing positive aspects of safety attitudes and four negative safety attitudes. The scores of negative safety attitudes in companies with fewer labor accidents were smaller than those in companies with more accidents. Negative safety attitudes were affected by safety climate more than positive ones, and this tendency was more remarkable for foremen than employees. These results suggest the importance of promoting safety climates for raising workers' safety attitudes and work site safety by diminishing negative safety attitudes.     

Safety self-efficacy and safety performance: potential antecedents and the moderation effect of standardization

PURPOSE: The purpose of this paper is to suggest a new safety self-efficacy construct and to explore its antecedents and interaction with standardization to influence in-patient safety. DESIGN/METHODOLOGY/APPROACH: The paper used a survey of 161 nurses using a self-administered questionnaire over a 14-day period in two large Israeli general hospitals. Nurses answered questions relating to four safety self-efficacy antecedents: enactive mastery experiences; managers as safety role models; verbal persuasion; and safety priority, that relate to the perceived level of standardization and safety self-efficacy. Confirmatory factor analysis was used to assess the scale's construct validity. Regression models were used to test hypotheses regarding the antecedents and influence of safety self-efficacy. FINDINGS: Results indicate that: managers as safety role models; distributing safety information; and priority given to safety, contributed to safety self-efficacy. Additionally, standardization moderated the effects of safety self-efficacy and patient safety such that safety self-efficacy was positively associated with patient safety when standardization was low rather than high. Hospital managers should be aware of individual motivations as safety self-efficacy when evaluating the potential influence of standardization on patient safety. ORIGINALITY/VALUE: Theoretically, the study introduces a new safety self-efficacy concept, and captures its antecedents and influence on safety performance. Also, the study suggests safety self-efficacy as a boundary condition for the influence of standardization on safety performance. Implementing standardization in healthcare is problematic because not all processes can be standardized. In this case, self-efficacy plays an important role in securing patient safety. Hence, safety self-efficacy may serve as a "substitute-for-standardization," by promoting staff behaviors that affect patient safety.     

医疗机构患者安全文化发展

系统地回顾国外患者安全文化政策理论研究、安全实证措施研究、安全测评工具调查研究的现状,以及通过对国内医疗机构特定人群的调查研究、患者安全文化量表引进和应用研究、安全文化的现状研究,查找目前国内医疗机构安全文化存在的矛盾问题:管理制度还不完善、医疗机构安全管理预警机制还未有效形成、患者安全文化相关性研究较为薄弱、患者安全文化测评研究不够全面。并提出加大医疗机构安全文化发展下一步意见建议:打造安全文化氛围,拓展安全文化外延,营造和谐医患环境等建议。     

赣州市大学生食品安全知识态度行为调查

目的调查赣州市大学生食品安全知识态度行为现况,为大学生食品安全教育提供依据。方法采取整群随机抽样法,利用自制问卷表对赣州市3所高校1800名大学生进行食品安全知识态度行为调查。结果赣州市大学生食品安全知识得分和知晓率较低,不同专业、性别大学生食品安全知识存在统计学差异,不同年级学生食品安全知识无统计学差异。大学生对食品安全态度较为积极,但对当前食品安全形势缺乏信心。在食品安全行为方面,广播电视及网络是大学生获得食品安全知识重要途径,也存在一些不良食品消费习惯。结论高校应加强对大学生的食品安全教育,使他们获得更多食品安全知识,改变不良的行为习惯,提高其食品安全意识。     

A comparison of the perceptions and beliefs of workers and owners with regard to workplace safety in small metal fabrication businesses

BACKGROUND: Problems of improving safety in small business establishments may include a lack of resources, limited unionization, and an informal management structure. METHODS: We evaluated worker and manager perceptions of worksite health and safety using Social Cognitive Theory. We used a business safety scorecard to audit the safety conditions, policies and programs, and work practices. Comparisons were made between the different measures. RESULTS: Businesses with safety committees had 1.7-2.1 times higher proportion of positive safety scorecard items than businesses without committees. Union status and business size were not associated with business safety audit results. Non-English-speaking and less educated employees reported higher levels of knowledge about safety than did their more educated and/or English-speaking peers. CONCLUSIONS: The presence of a safety committee is the single most important indicator of workplace safety. Self-reported understanding of workplace safety is greater among employees who do not speak English or have lower levels of formal education. Future worksite interventions should consider the need for participatory worksite safety committees. Multilingual training programs would help reach a greater proportion of workers.     

江苏农村地区食品安全知信行问卷调查

目的了解农村消费者对食品安全的认知、态度与行为现状,揭示农村食品安全现状及其深层次原因,探讨提高农村食品安全水平的对策与建议。方法开展2 697名居民问卷调查。结果调查地区消费者食品安全知识总体知晓率为26.30%;地区经济越发达,食品安全知识知晓率和食品安全关注率越高。结论消费者食品安全知识匮乏,维权意识差、成本高、难度大,农村食品安全形势严峻,需加大农村地区食品安全知识的宣传普及,充分发挥群众监督作用,充分保障农村地区食品安全。     

刍议医疗机构档案安全体系建设

该文深入分析和研究目前医疗机构构建档案安全体系的必要性和重要性。从安全意识、安全基础建设、安全管理、安全备份、安全技术等方面,提出建设医疗机构档案安全管理体系的有效途径。     

安全医院研究

受自然灾害的影响,安全医院已成为新时期医院建设高度关注的领域.安全医院的研究包括医院设计的全过程,既包括传统的安全概念范围内的安全防范,如医疗设施内消防安全、患者安全等,也包括非传统安全的防范,如自然灾害、工业交通事故、恶意暴力攻击等.文章主要论述了医疗建筑中结构安全和非结构安全的内容.