静脉输液现状与药学服务

目的:了解临床静脉输液工作的现状,探讨药师提供药学服务的切入点,减少药品不良反应发生,提高临床输液的安全性。方法:实地考察临床输液配制室条件,观摩和询问护师配制操作;查阅医师医嘱,面对面走访住院患者,询问其输液情况及对输液相关知识的了解。结果:走访的72例住院患者100%接受了输液治疗,平均使用注射剂7种(不包含作为溶媒的大容量注射剂),中药注射剂被广泛使用,平均输液时间7d;药物使用方法不当偶有发生;临床输液制度较为完善,但操作环境尚有缺陷;多数护师输液操作熟练,但对药物特别是新药的理化性质、药物配伍变化掌握尚有欠缺,输液过程中出现颜色改变或溶液混浊等现象偶有发生;患者对输液危害了解不够。结论:药师需要参与临床工作介绍药品知识,特别介绍新药理化性质,参与培养静脉输液护师专业队伍,有条件的医院应成立静脉输液配制中心,并加强对患者输液安全教育。

Status Quo of Intravenous Infusion and Pharmaceutical Care

OBJECTIVE：To investigate the status quo of intravenous infusion,to explore the breakthrough point for pharmacists to provide pharmaceutical care,to reduce the occurrence of ADR and to improve the safety of intravenous infusion.METHODS：The conditions of clinical infusion preparation room were investigated on-the-spot.The preparation operations of nurses were observed and consulted;physician medical advice was looked up.Face-to-face visit was carried out to inpatients to inquire about the situation of their infusion and the related knowledge of infusion.RESULTS：72 inpatients were all received intravenous infusion therapy.Averagely 7 kinds of injections（not including large volume injection as solvent）were involved.TCM injection was used widely.The infusion duration was 7 days averagely.Unreasonable utilization of drugs occurred occasionally.There was complete clinical infusion system,but there were still defects in the operation environment.Most of nurses mastered infusion skill,but weren＇t familiar with physical and chemical properties of new drugs or drug compatibility.The change of color and solution turbidity occasionally occurred during infusion.Patients poorly understood the risk of intravenous infusion.CONCLUSION：The results of survey suggest that pharmacists should be involved in the introduction of drug knowledge in the clinic,especially physical and chemical properties of new drugs,and participate in the intravenous infusion training of nurses.Qualified hospital should set up PIVAS,and strengthen the infusion safety education among patients.