某院静脉用药调配中心利用质量管理工具干预成品输液使用效果分析

目的 规范静脉用药调配中心（PIVAS）配置的抗感染药物及细胞毒性药物成品输液的使用，保证患者合理安全用药。方法 选取说明书中对药品使用方法 和注意事项有特殊说明的抗感染药物和细胞毒性药物的住院医嘱1046组，利用质量管理手法针对临床产生的主要问题（未立即使用、未避光、未按给药间隔使用）进行干预（优化信息系统、流程改造、加强沟通、宣教、用药手册），采用卡方检验对干预前后临床未正确使用PIVAS输液发生率进行统计学分析，观察干预效果。结果 干预后未按要求间隔给药时间的发生率从98．9％下降到56．6％；干预后未按要求立即使用的发生率从87．3％下降到40．1％；干预后未按要求避光的发生率从100．0％下降到40．8％，均有显著性改善。结论 采用优化PIVAS信息系统、流程改造、加强沟通、宣教、用药手册等措施对成品输液的使用效果干预有效。

Using quality tools intervention finished transfusion using effect analysis in PIVAS of a Hospital

Objective Standardize the use of anti-infective agents and cytotoxic agents which was blended by Pharmacy Intravenous Admixture Service （PIVAS）, in order to ensure that patients in the rationality and safety in the process of drug use. Methods Selected 1 046 hospital doctor＇s advices which including the anti-infective agents or cytotoxic agents which were signed the special usages in their leaflets, then used quality control technique to intervent the clinical problems （such as didn＇t use immediately, didn＇t avoid light, didn＇t use according to the dosing interval）. The intervention including optimizing the information systems, modificating working process, strengthing communication, propaganda and education, compiling medication guide. Used the chi-squared to analysis wrong usage rate before and after the intervention. Results After intervention, the rate of failure to delivery time interval decreased from 98.9% to 56.6%, the rate of not using immediately decreased from 87.3% to 40.1%, and the rate of failure to avoid light decreased from 100.0% to 40.8%,with significantly improved. Conclusion With the measure of optimizing PIVAS information systems, processing transformation, strengthening communication, education, medication and other measures, the use of manual infusion intervention has an efficacious effect.