病区高危药品的规范化管理

目的探讨病区高危药品规范化管理方法,确保用药安全。方法制订高危药品目录,规范高危药品管理工作流程,加强对护理人员的培训,保证管理制度的有效落实。结果对病区实施高危药品管理及进行高危药品管理质量考核,护士取、用药准确率显著高于实施病区高危药品规范化管理前（P〈0．01）。结论病区高危药品规范化管理,可加强护理人员的责任心和安全防范意识,保证用药安全,防范护理差错、隐患的发生,提高护理质量。     

品管圈在病区高危药品管理中的应用

目的:探讨品管圈在病区高危药品管理中的应用效果。方法:成立品管圈组织,选定提高病区高危药品管理质量,确保临床用药安全为活动主题,对病区高危药品管理现状进行调查与分析,圈员共同拟定对策,并组织实施。结果:实施品管圈后病区高危药品质量检查结果明显高于实施前(P0.01),护理人员对高危药品知识的掌握程度明显提高(P0.01)。结论:品管圈活动应用在病区高危药品管理提高了护理人员对高危药品的管理意识,使病区高危药品管理质量得到了显著提高。     

产科病区实施高危药品管理的方法与效果

目的规范产科病区高危药品的管理方法,提高护理人员用药、取药的准确率,确保孕产妇用药安全。方法成立高危药品管理小组并制订管理制度;制订高危药品目录;加强相关知识培训,规范高危药品放置;规范高危药品的使用、检查及交接。结果规范高危药品管理后,药品质量管理得到保障,高危药品质量检查结果比实施前有所提高。结论实施高危药品管理,能提高护理人员对高危药品的风险管理意识及临床用药安全。     

ICU高危药品安全管理的方法与效果评价

目的:规范ICU高危药品管理,提高临床用药安全。方法:在病区成立高危药品安全管理小组,制定和完善ICU高危药品目录,进一步规范高危药品管理制度,对护士实行高危药品知识培训及考核、资格准入,强调高危药品使用前后双人查对制度及用药后效果观察、不良反应监测。结果:安全管理实施后高危药品管理缺陷发生率低于安全管理实施前(P0.05)。安全管理实施后护士对高危药品安全管理及使用相关理论知识掌握情况显著高于安全管理实施前(P0.05)。结论:规范ICU高危药品安全管理能有效提高护理人员的安全用药能力,确保患者安全。     

普外科高危药品的用药安全管理

根部护理部高危药品细则制定普外科高危药品管理制度,加强科室护理人员的高危药品相关知识培训,制定高危药品用药流程和管理制度。结果普外科的高危药品实现了科学的规范化管理,增强了病区护士对高危药品的认知,提高了病区护士对高危药品使用的防范意识,减少了病区高危药品使用安全隐患。     

ABC 分类法在病区高危药品安全管理中的应用

目的:采用ABC分类法对病区高危药品进行科学有效的安全管理,提高高危药品管理水平,确保病人用药安全。方法:健全病区高危药品管理制度,加强药物安全管理知识培训,采用ABC分类法将病区高危药品进行分类管理,标识醒目,建立统一的评价考核标准,检查制度落实到位,防止出现药品混放、过期、变质药品;防止药物储存条件不当导致药品疗效下降,保证安全用药。结果:ABC分类管理后药品管理效果优于ABC分类管理前(P<0.05)。结论:ABC分类法用于病区高危药品的管理,能提升病区药品管理水平,保证用药安全,有效杜绝了用药差错。     

急诊科实施高危药品管理的方法与体会

目的:探讨急诊科高危药品的管理方法,提高护士对高危药品的管理意识,确保用药安全.方法:制订高危药品目录;完善高危药品管理体系,落实职责;加强高危药品知识培训,规范护理人员用药操作程序.结果:规范高危药品管理后,根据药品质量检查标准进行质量控制,高危药品质量检查结果比实施前大大提高,药品质量管理得到保障.结论:实施科学的高危药品管理,能有效提高高危药品的用药安全性,保证护理质量.     

自制护理用药安全手册用于患者安全管理

目的：了解目前临床用药中护理差错发生的原因,探索相应的对策以确保用药安全。方法针对2011年医院41个护理单元上报用药不良事件及11月开展用药安全专项检查存在的问题进行原因分析,制定用药安全手册,包括健全各种用药安全管理组织及制度,收集临床多品种、多规格、看似听似药品拍成图片进行比对,临床应控制滴速、接触易发生反应药物,药物配制信息,药物配伍禁忌,宜从中心静脉输注的药物,高危药物外渗紧急处理,抢救药物药理知识,以表格形式进行罗列。规范使用药物流程、组织培训与考核等一系列措施。结果2012年护理用药不良事件总数较2011年减少15起,下降18．5％。与2011年相比,2012年用药专项月检查存在问题,通过护理用药安全手册的制作与应用,加强了用药安全管理,促进护理人员掌握药品管理及用药知识,有效提高了护理人员用药安全能力,保障了患者用药安全。结论该手册为护士临床用药安全提供参考,起到临床用药指引作用,有效提高了护理人员用药能力。     

等级医院评审中参照JCI标准加强病区高危药品管理的实践

目的加强病区高危药品的管理,减少或避免高危药品用药错误的发生保证患者安全。方法参照国际医疗卫生机构认证联合委员会药品管理原则,从制度建立、药品品种确立、存储环境、效期管理、警示标识、专区或专柜存放、专人管理、人员培训等方面进行行政管理和技术干预,比较规范化管理前后的高危药品管理合格科室率。结果与规范前相比,规范后的高危药品管理合格科室率均明显升高(P0.01)。结论参照国际医疗卫生机构认证联合委员会制定的标准加强病区高危药品规范化管理能有效促进病区药品管理规范,保障病区高危药品管理使用安全有效。     

持续质量改进在高危药品管理中的应用

在高危药品管理中应用持续质量改进方法,强化对高危药品风险管理,建立安全管理组织,健全安全管理制度,全院统一标识,统一位置放置,全院统一发药、给药流程,利用计算机设置屏障,让患者参与给药的查对,对医务人员进行培训与考核,调动人员的主动学习意识,积极参与高危药品的管理,有效提高护理人员的安全用药能力保障患者安全。     

对新护士进行高警讯药物知识专题培训的实践

目的研究如何通过培训提高新护士的高警讯药物知识及用药安全意识。方法对进院2年内的新护士进行专题培训20学时,并进行考核。结果新护士高警讯药物理论与操作技能考试成绩显著高于培训前（P〈0．01）,用药差错与护理缺陷明显减少。结论高警讯药物知识专题培训可提高护士的相关药物知识与临床用药安全管理质量。     

Medication errors in emergency rooms, intensive care units and pediatric wards

Medication safety is a major concern worldwide that directly relates to patient care quality and safety. Reducing medication error incidents is a critical medication safety issue. This literature review article summarizes medication error issues related specifically to three hospital units, namely emergency rooms (ERs), intensive care units (ICUs), and pediatric wards. Time constrains, lack of patient history details and the frequent need to use rapid response life-saving medications are key factors behind high ER medication error rates. Patient hypo-responsiveness, complex medication administration and frequent need to use high-alert medications are key factors behind high ICU medication error rates. Medication error in pediatric wards are often linked to errors made by nurses in calculating dosage based on patient body weight. This article summarizes the major types of medication errors reported by these three units in order to increase nurse awareness of medication errors and further encourage nurses to apply proper standard operational procedures to medication administration.     

西药房高危药品的管理与用药安全分析

目的分析西药房高危药品的管理与用药安全性。方法将2017年8月至2018年7月(常规高危药品管理)、2018年8月至2019年7月(针对性高危药品管理)两个时间段分别设为对照组、观察组,比较两组的高危药品不合理用药情况及药物不良事件发生情况,并调查两个时间段工作人员的高危药品知识知晓程度。结果观察组的不合理用药总发生率、药品不良事件总发生率分别为1.67%、4.00%,低于对照组的8.33%、14.00%,差异具有统计学意义(P<0.05)。观察组工作人员的高危药品知识知晓程度明显优于对照组,差异具有统计学意义(P<0.05)。结论在西药房实施针对性的高危药品管理,可提高用药安全性。     

Descriptive analysis of workflow variables associated with barcode-based approach to medication administration

Bedside barcode technology is used during medication administration to ensure patient safety. This study evaluated the workflow variables related to a bedside barcode technology-based medication administration process. A time-and-motion technique was used to assess the observational episodes related to medication administration conducted by registered nurses. In an observational episode, nurses spent adequate time in "documenting medications" and "giving medications." Nurses were primarily engaged in tasks at the patient's bedside.     

Application of the 80/20 rule in safeguarding the use of high-alert medications

Critical care units are busy, complicated settings where the margins of error are narrow and the challenges to patient safety are ever present. Applying the 80/20 rule, front-line nurses can reduce medication errors by focusing on the safe use of "high-alert" medications. There are three primary principles that practitioners can use for safeguarding against medication errors that may result from high-alert drugs. These include: reducing or eliminating the possibility of errors, making errors visible, and minimizing the consequences of errors. These principles constitute a framework of safety that guides the development of proactive error reduction strategies.     

Medication safety challenges in the palliative care setting: Nurses' perspectives

AimTo explore medication safety issues faced by general and palliative care community nurses working in rural and remote palliative care domiciliary settings.MethodAn online survey for nurses working in rural communities was conducted across the South East region of rural Victoria, Australia. Nurses from 18 community based health care organisations across the region were invited to participate in an anonymous survey addressing medication safety issues in the palliative care settings. Qualitative data obtained from the open-ended survey questions were analysed inductively.ResultsA total of 29 nurses completed the survey (response rate 28% from potential respondents). Most of the nurses were working in a rural practice providing a mixed model of community palliative care and community nursing. Medication safety issues raised by the nurses included; errors associated with dose administration aids, frequency of medications reviews undertaken by clinical pharmacists of clients’ medications, high occurrence of medications error reporting, lack of awareness of medications initiated by nurses and cytotoxic medications handling.ConclusionTargeted interventions addressing the identified issues raised by community general and palliative care nurses have the potential to improve medication safety in the domiciliary palliative care setting.     

Medication administration evaluation and feedback tool: Longitudinal cohort observational intervention

BackgroundMedication administration by nurses is a complex task requiring multiple steps to ensure patient safety. A medication administration evaluation and feedback tool (MAEFT) incorporating self-assessment, direct observation, and feedback has been developed and tested previously for reliability.AimTo describe nurses’ medication administration practice when followed up with self and peer evaluation and feedback using the MAEFT.MethodsFour nurse evaluators were trained to use the MAEFT. Twenty-eight nurses participated in the study to be observed administering medications in the clinical setting. The initial observations were conducted over four weeks, with follow-up four months later. The MAEFT contains 22 criteria, against which the nurses were evaluated. For each criterion, an evaluation of whether it was performed (“yes” or “no”) was made. The overall score was calculated as a percentage of the number of criteria performed.FindingsThere was a high standard of criteria performed, with median overall observer scores of 95% at time 1 and 94% at time 2. Criteria not performed demonstrated 71 potential medication errors at time point 1, with only 33 at time point 2.DiscussionThere was no difference in nurses’ practice using the MAEFT when followed up, but there was no baseline control to determine the current practice before using the MAEFT. However, there was a reduction in the number of medication errors.ConclusionNurses’ medication administration practice standards remained high when followed up with self and peer evaluation and feedback using the MAEFT. More criteria were checked during the follow-up evaluation.