Point-of-care immunotesting: approaching the analytical performance of central laboratory methods

The use of point-of-care (POC) immunoassays has increased significantly and the menu of analytes continues to expand. Most of the rapid immunoassays are currently based on simple manual assay devices such as the immunochromatographic, agglutination, and immunofiltration assays. Although automated readers have recently been introduced at an increasing pace, the major benefit of these genuinely hand-portable assay devices is that they do not usually necessitate instrumentation but can be performed anywhere. Significant advances in assay and detection technologies have, however, recently facilitated the introduction of truly quantitative, sophisticated immunoassay methods to POC settings as well, with the analytical performance characteristics approaching those of conventional laboratory assays. Furthermore, innovative assay technologies such as those based on immunosensors have been introduced to POC testing (POCT) without ever being employed in clinical laboratories. However, further simplification of the assay procedures and analyzers is still feasible, and strong efforts are directed towards the development of miniaturized and simple, yet sensitive and quantitative, novel assay technologies to keep up with the increasing expectations set on future POC immunotesting.     

住院药房口服单剂量调配的差错案例分析与措施改进

目的 降低该院口服单剂量调配差错,为提升医院住院药房口服单剂量调配工作质量提供借鉴。方法 统计西安交通大学第一附属医院2016年3—6月口服单剂量调配差错数据,应用差错类型分析法对各类型差错的典型案例进行分析,找出问题的关键并制定相应的防范措施,措施实施3个月后,统计分析2016年9—12月的差错数据以观察实施效果。结果 制定的防范措施主要包括优化工作流程、加强业务培训及复核确认、系统软件优化等;措施实施后差错发生率由0.231‰下降为0.062‰,其中人为因素导致的差错由152例下降为33例;机器自身因素导致的差错由105例下降为38例。结论 所采取的措施可有效降低口服单剂量调配的差错发生率,提高了工作质量,保证了病人口服用药的安全。     

我院住院药房全自动单剂量药品分包机应用前后的效果评价

目的:比较住院药房应用全自动单剂量药品分包机摆药与手工摆药2种模式的优劣。方法:通过回顾性分析方法,从工作流程、分包药师人数、服务病区数和床位数、药品准备和摆药及核对时间、分包数量、分包速度、分包准确率、日耗材成本、人力成本、固定维修保养成本及用药安全等各方面进行比较。结果与结论:与手工摆药比较,分包机摆药模式下单剂量分包所需的药师数量、药品准备和摆药及核对时间、日耗材成本和人力成本均减少;服务病区数和床位数,分包数量、速度、准确率和用药安全都得到提高。虽不应忽视药品分包机带来的固定维修及保养成本,但其使用可将药师的工作时间更多地运用于提高药学服务水平上,值得推广应用。     

我院自动包药机单剂量调剂模式实施情况及体会

目的:为自动包药机的使用提供借鉴。方法:从管理制度等方面介绍我院自动包药机单剂量调剂模式实施情况,统计、分析其试运行及调试后的差错率,同时与人工调剂口服医嘱进行强度及准确度比较。结果与结论:通过人员管理、自动包药机管理、药品管理等制度的建立规范其操作流程;通过对自动包药机的调试,机器故障、医嘱错误差错率分别由0.085‰、1.15‰降低至0.009‰、0.09‰,人工加药错误、网络原因产生的差错均分别由0.021‰、0.085‰降低至0;与人工调剂口服医嘱相比,自动包药机的包药量是其1.73倍,差错率仅约为其1/8,包药时间约为其4/5。使用自动包药机可明显提高药品调剂的工作效率,降低了药品污染,保障了调剂人员的安全,但缺乏大容量的药品包装是目前亟待解决的问题。药师应积极与工程师沟通、协调,不断根据运行中的具体情况,对包药机的程序重新设置或调试,以使其在调剂药品时更加准确、有效。