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Survey of wastage from intravenous admixture in US hospitals 总被引:2,自引:0,他引:2
The purpose of this study was to assess current wastage from intravenous systems designed for intermittent use in US hospitals. Questionnaires were mailed to pharmacy directors at 1393 randomly selected hospitals. Respondents were asked to indicate their overall percentage intravenous wastage rate, intravenous admixture policies and procedures, and wastage rates for currently used intermittent intravenous drug delivery systems. If actual data were not available, respondents were asked to provide estimates based on their perceptions of waste. A total of 237 (17.0%) usable responses were returned. The mean intravenous wastage was 2.85% (+/- 3.40) for respondents who provided actual values and 4.28% (+/- 3.83) for respondents who provided estimated values. Lower mean wastage rates were found for hospitals which: (a) received written notification of discontinued intravenous systems; (b) had an elapsed time of less than or equal to 1 hour from discontinuation of the intravenous system to notification in the pharmacy; (c) actively retrieved discontinued intravenous systems from the nursing unit; and (d) had a daily return of discontinued intravenous systems to the pharmacy. Based on actual values provided by respondents, for 9 intravenous systems the mean wastage rates were lowest for commercially prepared intermittent systems such as frozen piggyback systems {1.5% (+/- 1.4)} and piggyback systems stored at room temperature {3.2% (+/- 5.2)}, and 4.4% (+/- 16.0) for nursing-activated ADD-Vantage systems. We expected that pharmacy managers would monitor waste regularly and be able to provide actual values for wastage rates. However, only 124 (53.3%) of the respondents provided actual data.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
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目的通过PIVAS在配置过程中出现的各类差错进行分析讨论,发现工作中出现的问题,总结相关的经验教训,整理改进措施。促进临床合理用药、减少和避免配置差错提供参考,提高医疗质量,保证临床用药安全。方法根据《中国药典》、《临床用药须知》、《临床静脉用药调配与使用指南》及JCI要求等相关规定,对我院静脉用药调配中心输液配置环节出现的各类差错进行回顾性原因分析总结,并提出相对应的防范措施。结果本文结合本院静脉药物配置中心工作中具体的差错例子对相应的情况进行了总结分析。其差错率主要集中在:电脑系统不够完善,医师医嘱不合理,审核人员差错,输液调配差错这四个方面。结论通过对调配过程中存在的差错分析,我们总结出:优化系统,增强审方药师业务技能,加强高危药品管理,建立差错制度等改进措施,来优化完善PIVAS的工作,使工作更加高质高效,有效杜绝差错事故的发生。 相似文献
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目的促进药师在临床营养支持中积极发挥作用,提高药师专业形象和药学服务效率。方法介绍了浙江大学医学院附属第二医院药师在肠内肠外营养支持中的工作模式以及成效。结果临床药师通过参与临床查房和医嘱开立、咨询、讲座宣教、药品不良反应会诊处理等,提供全程药学监护。病区药剂作业的药师通过严格的收费前医嘱审核、与临床医生积极沟通、肠外营养液的集中配置、处方点评和流程管理,保证肠外肠内营养的合理性和使用安全性。不同岗位药师开展了相应的药学服务,互相合作取得了较高的临床满意度。结论肠内肠外营养的合理用药干预需要团队合作,临床药师和药剂作业的一线药师需要紧密合作,从不同的侧重点切入,点面结合,才能将药学服务做精做细。 相似文献
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Mercy Hospital, in cooperation with McGaw Laboratories, conducted a pre-marketing evaluation of a new intravenous solution container made of a polyallomer thermoplastic, polyolefin. Following a four-month evaluation period using the Accumed container in the pharmacy intravenous admixture program and on all nursing units, the container was evaluated by both the pharmacy and nursing staffs and compared with our present system, Viaflex. A questionnaire prepared and supplied by McGaw Laboratories allowed nurses to evaluate the container subjectively. A questionnaire was also prepared for members of the pharmacy staff, both professional and supportive personnel, to use in evaluating the container. In addition, a time and motion study was developed to compare the Viaflex, Travenol glass, and Accumed containers in all areas of the hospital where intravenous solutions were used. Both the subjective and objective evaluations demonstrated acceptance by the Departments of Pharmacy and Nursing, and the Accumed container performed comparably with the Viaflex and glass containers tested in intravenous admixture preparation and in their administration. A list of properties of the "ideal" system is proposed. 相似文献
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目的以静脉用药调配中心(PIVAS)为平台,发挥临床药师的专业职能,促进临床合理用药。方法临床药师通过审核医嘱,参与临床用药过程,指导临床合理用药。结果静脉用药调配中心工作的开展,加强了医药护之间的联系和沟通,切实提高了合理用药水平。结论静脉用药调配中心是开展临床药学服务的重要场所,已成为以合理用药为核心的药学服务的重要内容。 相似文献
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发挥药师在静脉药物配置中心的作用,促进合理用药 总被引:35,自引:0,他引:35
目的:依托静脉药物配置中心工作平台,增强药师作用,促进合理用药,降低医疗费用。方法:统计与分析静脉药物配置中心建立前后工作人员、卫生材料、药品的消耗情况。通过审核病区医嘱,纠正不合理用药。结果:共审核医嘱162 733份,发现不合理医嘱367份(0.23%),纠正345份(医嘱修改率94%);静脉药物配置中心建立后降低医疗费用61 845元,大输液的账物相符率达99.46%。结论:静脉药物配置中心的建立,充分发挥了药师在合理用药中重要作用。 相似文献
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The establishment of a centralized, intravenous solution/admixture drug program in a hospital enhances the quality of patient care. Costs for personnel, equipment, and space have constrained the growth of such a service in the past. A method of preparation for admixture units, which capitalizes on the economics of volume and employs personnel at levels of training consistent with need, is proposed. This technique, utilizing freezing, long-term storage at -20 degrees C, and thawing by exposure in a microwave oven minutes before intended use, surmounts the real and perceived difficulties in many planned or existing admixture programs. A strong element of prospective quality control can be introduced. Where demand is insufficient to justify a separate activity, cooperative arrangements among hospitals will bring all the advantages of central admixture to each. It appears that reductions can be made in the pharmacy hours devoted to admixture. Waste of any unused, reconstituted drugs or prepared units that were not administered may be diminished. Thus, there may be substantial savings for existing admixture programs, if the technique described is adopted. The ultimate form of implementation in each institution, as always, is dependent upon the special "personality" of the hospital. 相似文献
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静脉药物配置中心洁净区的微生物污染控制管理 总被引:1,自引:0,他引:1
目的探讨静脉药物配置中心(PIVAS)洁净区微生物污染原因,进一步完善洁净区微生物污染控制程序及相关管理制度。方法2005至2008年,在PIVAS洁净区面积与室内设施不变的情况下,在不同管理要求下每月1次监测紫外线灯辐照强度,对空气、物体表面、工作人员手部、使用中的消毒液进行细菌监测,每半年1次对洁净区相关室间进行洁净度监测(包括尘埃粒子、浮游菌、沉降菌)计数,并将监测结果进行分析、总结,针对存在问题,进一步完善微生物污染控制程序的部分环节,继续追踪考察所有监测数据,判断整改措施是否有效。结果通过完善、落实微生物污染控制程序,紫外线灯辐照强度合格率从78.5%升至95%;空气细菌总数合格率从90%上升至99%。结论该措施能有效预防微生物污染和保障静脉药物配置的安全。 相似文献
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静脉药物配置中心有效运行的探索和实践 总被引:1,自引:1,他引:1
目的:合理协调静脉药物配置中心(PIVAS)工作,确保PIVAS工作的有序开展,为正在或将要运行PIVAS的医院提供借鉴和参考。方法:通过上海交通大学医学院附属瑞金医院PIVAS的运作情况,介绍配药信息的传递、药物配送、退药、不合理用药的处理以及信息化管理等工作的实践经验。结果:及时协调、处理运行PIVAS中出现的各类问题,确保PIVASI作顺利开展,满足临床静脉用药的需要。结论:加强各环节的规范和协调,保证PIVAS的有效运行,实现医院药学由单纯供应保障型向技术服务型转变。 相似文献
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我院静脉药物配置中心差错分析及控制措施 总被引:8,自引:0,他引:8
目的:为保障临床用药安全,避免药疗差错提供参考。方法:根据药品说明书、《中国药典》、《临床用药须知》等相关规定,对2006~2007年我院静脉药物配置中心出现的各类差错进行分析,并针对性地制定了控制措施。结果:静脉药物配置中心的内差率为0.04%,差错率为0.001%,主要发生在医师医嘱、护士录入医嘱、药师排药、护士配置、成品核对等工作环节。结论:可通过构建完善的质量安全管理体系、提高药师审方能力、加强工作人员的管理、加强核对制度等措施降低差错发生,促进临床合理用药。 相似文献
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对静脉药物调配中心的药物调配残留量进行质量控制,旨在保障输液的有效性。通过分析3年来残留量质量控制结果,发现药品调配残留量超标率为7.0%,残留量主要影响因素有:调配人员专业知识、调配手法、劳动强度、责任意识,可以此为药品调配改进提供方向。 相似文献
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静脉药物配置护士差错分析与控制措施 总被引:2,自引:0,他引:2
目的为保障静脉药物配置安全,减少和避免药疗差错提供参考。方法根据药品说明书、《中国药典》、《临床用药须知》等相关规定,对2006年8月至2009年8月我院静脉药物配置中心配置护士差错进行分析,并针对性地制定了控制措施。结果静脉药物配置护士内错率为0.005%;差错率为0.0036%。主要发生在未实行两步稀释法、漏做标记、混淆药品规格、药物剂量不准确、全营养混合液顺序有误等工作环节。结论配置护士必须加强药学知识和药品说明书的学习,加强职业道德教育,提高责任心,及时修正其不良行为,才能将差错发生率降至最低,保证药物安全性和有效性。 相似文献